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POWERED BY THE JERRY J. DAWSON CIVIC LEADERSHIP INSTITUTE IN MACON COUNTY ILLINOIS

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Student Application to Apply for DCLI Participation

We hope you are interested in DCLI’s programming – there is no cost to participate in any area.  The way to register for any club or program is to complete the information below.  Feel free to select all programs that you are interested in.

STUDENT INFORMATION

Please Select:

PARENT OR GUARDIAN INFORMATION

We believe that collaboration with parents and family is important to encourage the success of our students. Please complete the following information.

DCLI PROGRAM INTERESTS

DCLI High School Programs

Please note that by signing your are authorizing that photographs and footage of you may be used by DCLI for marketing and publicity in our publications, on our website and in social media or in any third party publication. Please contact us if you have any concerns or if you wish to be exempted from this authorization.

Thanks for submitting!

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