DCYAC_Application

Online DCYAC Application

General Information

Name

Phone

Email Address

Sex

Male

Female

M/D/YYYY

Address

Graduation Date

M/D/YYYY

Date of Birth

School Training Program

Zip Code

Ward

Employment Information

Are you currently employed?

Yes

Employer

Work Hours

Parent/Guardian Information

Name

Home Phone

Parent Email

Daytime Phone

Alternate Emergency Contact Name

Alternate Emergency Contact Daytime Phone

Ethnicity (Optional)

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I am applying to the DC Youth Advisory Council to represent ward

1.) What are the three most important issues that affect your community?

2.) Choose one of the issues above and explain how you would address the issue as a community leader. (500 word max)

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3.) Why should you be chosen to serve as a member of the DC Youth Advisory Council? What personal skills and/or characteristics can you bring to the DCYAC? (500 word max)

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4.) Please list the organizations with which you are currently involved (include school, community, and employment). Indicate whether these organizational commitments will conflict with your ability to actively engage in council related activities. (500 word max)

I certify that the information I have given is true and correct to the best of my knowledge.