Cedar Hills Youth City Council Application

Section I: Application

To be completed by Teen Applicant in the 9th through 12th grades during the upcmong school year.

What name do you like to go by?

Applicant's Email

Applicant's Cell Phone

Applicant's Home Phone

Applicant's Street Address in Cedar Hills

Please provide the name of someone to contact in case of an emergency

Relationship of Emergency Contact to Applicant

Phone Number of Emergency Contact

Section II: Questionnaire

Are you committed to attending two (2) YCC meetings per month?

Yes

If "no" please explain:

Are you committed to participating in three to five YCC-sponsored service events throughout the year?

Yes

If "no" please explain:

Which YCC activities and service events would you like to see continued or changed, or what new activities and service events would you like to see take place? (If no comment, say "None.")

Are you interested in serving in any YCC leadership positions?

What extra-curricular activities are you committed to for this following year?

Have you talked to your parents about applying for Youth City Council? If not, please discuss it with them and ask them to submit the Parental Consent Form, and ask an unrelated adult to submit the Recommendation Form. Both of these forms are available at cedarhills.org/youth-city-council and are needed to complete your application. Thank you!

Section III: Submit a Head Shot

Upload File

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Section IV: Commitment Agreement

I understand that membership on the Youth City Council is dependent on my maintaining a good behavior standing at school, including positive grades. I understand that behavior infractions in school or legal infractions may result in my forfeiting my seat on the Council.

I understand that I pledge to remain drug and alcohol free. If I am found to be in violation of school policies or legal infractions involving drugs and/or alcohol, I will forfeit my seat on the Council.

I understand that involvement on the Youth City Council demands consistent attendance. A total of three (3) unexcused absences may constitute consequences.

I understand that my time commitment for this council is 1-2 hours per week.

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Applicant's Signature:

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Date

Dear YCC Applicant,

Your application is not complete without the submission of the Parent/Guardian Consent Form and the Recommendation Form, which are both provided on the YCC page on the city's website. Please ask a teacher or an unrelated adult friend who knows you well to submit the Recommendation Form. You may now submit your part of the application. Thank you!