Please let us know what your disability is. If you would rather not, please type “I do not wish to provide this information.”
Please enter your district in the following format, using the example of California’s 45th District: CA-45
Please enter a few sentences reflecting on your experience earning the Gold Medal. You may feel free to submit the same reflection that you did for your online record book. This reflection will be included in your medalist profile that is submitted to your Member of Congress prior to your meeting with them.
In a few words, describe the activity you completed for the Voluntary Public Service program area. If you completed multiple activities, focus on your main activity or consolidate them into a broader category. This note will be included in your medalist profile that is submitted to your Member of Congress prior to your meeting with them.
In a few words, describe the activity you completed for the Personal Development program area. If you completed multiple activities, focus on your main activity or consolidate them into a broader category. This note will be included in your medalist profile that is submitted to your Member of Congress prior to your meeting with them.
In a few words, describe the activity you completed for the Physical Fitness program area. If you completed multiple activities, focus on your main activity or consolidate them into a broader category. This note will be included in your medalist profile that is submitted to your Member of Congress prior to your meeting with them.
In a few words, describe the activity you completed for the Expedition/Exploration program area. If you completed multiple activities, focus on your main activity or consolidate them into a broader category. This note will be included in your medalist profile that is submitted to your Member of Congress prior to your meeting with them.
