Our Programs / In the Lead 180

Refer a Youth (14-17)

Now Accepting Referrals From Across Alberta

In the Lead 180 is an innovative leadership and character-building program for young people involved in the justice system who show leadership potential. In the Lead 180 reaches young people in our Province who are struggling to use their natural leadership ability in beneficial ways or believe in their potential. Where others might see deficits and risk, we see strengths and possibility. Our strength-based, leadership curriculum encourages young people to transform their views of themselves, their communities and their futures.

In the Lead 180 is now accepting referrals from Provincial Law Enforcement Agencies, Probation Officers, and Youth Justice Committees for our online programming.

ITL 180 is a weekly online class and cycles through 6 weeks of curriculum. Referrals are accepted anytime. Young people do not need to wait until Class 1 to participate, and our classes are designed to welcome and include new referrals each week.

You may contact us for more information by emailing inthelead180@cyjs.ca.

In the Lead 180 Referral Form

14-17

Please feel free to reach out if you have any questions or concerns. We are happy to connect with you and the youth you are nominating.

Contact Information:
inthelead180@cyjs.ca

In The Lead 180 (Youth Aged 14-17) Referral Form

Please complete all fields - this referral form must be fully completed for youth aged 14-17 participation and registration. Please Note: You will receive a certificate of completion from In the Lead via email when the youth has successfully completed the program.

"*" indicates required fields

Company

This field is for validation purposes and should be left unchanged.

Youth's Legal Name*

First Last

Youth's Name For Class (If Different From Above)

Youth's Date of Birth*

The youth must currently be 14-17.

Youth's Gender (Ex: Female, Male, Nonbinary, Other)*

Youth's Pronouns (Ex: He/Him, She/Her, They/Them, Other)*

Youth's Phone Number*

Youth's Email*

What is the youth's ethnicity? (If unknown, please write "unknown.")*

Was the youth born in Canada?*

Yes

Unknown

If the youth was not born in Canada, what country were they born in?*

If the youth was not born in Canada, what was the date of arrival?

What is the youth's citizenship status?

What is the youth's current housing situation?

What is the youth's highest level of education completed?

Parent/Guardian Name*

Parent/Guardian Phone Number*

Parent/Guardian Email*

Youth's Address*

City (Street Address Not Needed) Province Postal Code

Alternate Parent/Guardian Name (If Applicable)

Alternate Parent/Guardian Phone Number (If Applicable)

Alternate Parent/Guardian Email (If Applicable)

ORCA/Police Case Number (If Applicable)

Notes Regarding Youth (If Applicable)

Type of Referral*

Direct Referral from Agency

Youth Justice Committee Referral

Referring Agency*

Calgary Referral

Provincial Referral (Outside of Calgary)

Calgary - Referral Source*

Provincial - Referral Source*

Referring Agency Name*

Referral Source Person - Name*

Referral Source Phone Number

Referral Source Email*

Date ITL 180 Must Be Completed By*

This date is required when ITL 180 is part of a sanction imposed by a Youth Justice Committee. The date must be prior to the return date to court.

Our Programs / In the Lead 180

Refer a Youth (14-17)

Now Accepting Referrals From Across Alberta

In the Lead 180 Referral Form

14-17

In The Lead 180 (Youth Aged 14-17) Referral Form

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