Are you a DCYAC alum? If so, we want to hear from you!
General Information
Name
Email Address
Address
Ward
1
2
3
4
5
6
7
8
Zip Code
Phone
M/D/YYYY
Date of Birth
Sex
Male
Female
School Information
M/D/YYYY
Graduation Date
Field of Study
Employment Information
Are you currently employed?
Yes
No
Employer
Ethnicity
African-American/Black
Hispanic/Latino
American Indian/Alaskan Native
Caucasian/White
Native Hawaiian/Pacific Islander
Other
N/A
1.) Which ward did you represent?
1
2
3
4
5
6
7
8
2.) Did you represent any other ward(s)? If so, which one?
None
1
2
3
4
5
6
7
8
4.) Would you like to receive our monthly online newsletter?
Yes
No
3.) Are you interested in serving as an Adult
Advisor?
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No
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