Student Champion Applications
Applications due on January 16th, 2026. Any questions can be directed to Sasha Gluzberg at sgluzberg@arcessex.org.
Name
*
First Name
Last Name
Current grade
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
School Name
*
Parent/guardian
*
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Why do you want to be a Champion for The Arc of Essex County’s Building Tomorrows 5K Family Walk and Fun Fest?
*
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Who has been a role model to you and why?
*
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Give an example of when you practiced inclusivity.
*
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What is one idea you have to get your friends or classmates involved in the 5K?
*
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