Mayor’s Youth Council Application
The vision for the Mayor’s Youth Council is to empower youth dedicated to personal development and servant leadership. If you are interested in applying for membership in the council, please complete the following application. Applicants must be City residents and be in grades 9 through 12. The applicant must complete the application in its entirety to be considered for the Mayor’s Youth Council.
Date of application
REFERRAL SOURCE:
Advertisement Relative Other
Name of referral source:
STUDENT APPLICANT INFORMATION
First Name: Middle: Last Name:
Address of Applicant:
City:
Telephone Number: Age
Email Address:
Parent/Guardian Name: Parent/Guardian Phone Number:
Parent/Guardian Email Address:
APPLICATION QUESTIONS
1. Please list any activities you will be involved in during the school year. Please include employment, sports, community, school, and other clubs or extracurricular activities.
2. What personal skills and characteristics do you possess to make you a good representative?
3. What would it be if you could bring one thing to this City or change one thing?
REFERENCES
Please list two adult references (non-relatives) with phone numbers.
DISCLOSURE
I have read and understand the commitment required for the Mayor’s Youth Advisory Council. I also acknowledge the importance of teamwork and cooperation, and I am willing to make this commitment.
Signature of Student: Student Signature Date:
Signature of Parent/Guardian giving permission for the student to be part of the Mayor's Youth Advisory Council if selected.
Emergency Contact Name:
Emergency Contact Phone Number: