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Youth Committee Application
1.Complete this application, answering all questions and providing all requested information.
2.Download parents form for website/parents sign and upload.
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* Indicates required question
Full Name
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Your answer
Mailing Address
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Your answer
Date of Birth:
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MM
/
DD
/
YYYY
Cell Phone Number:
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Your answer
Email
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Your answer
High School Name & Grade
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Your answer
T-SHIRT SIZE (adult sizes):
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Your answer
STUDENT COMMITMENT: If selected, I agree to lead a drug free lifestyle and attend 70% of CDFY events including any monthly meetings.
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Yes (means agreement)
List five (5) adjectives that describe you.
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Your answer
Describe why would you like to be involved in the youth committee?
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Your answer
List the extra-curricular events, activities, and opportunities that you are involved in. Include both school and community activities.
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Your answer
What are some of the issues in the community concerning local youth and teens that you think the Youth Committee could address, focusing on the community and city?
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Your answer
How did you hear about the Youth Committee?
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Through a Friend
Social Media
School
Website
Other:
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This form was created inside of Jefferson City's Council for Drug Free Youth.
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