STONEVILLE YOUTH COUNCIL APPLICATION

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The vision for the Stoneville Youth Council is Stoneville's caring youth dedicated to personal development and servant leadership will be empowered to meet the needs of the youth of our community. If you are interested in applying for membership to the council, please complete the following application. Applicants must be a resident of the McMichael High School attendance zone with a 27048 zip code and be a student between the ages of 14 - 19. All information must be completed and returned by midnight April 30, 2023 to be considered for the Stoneville Youth Council.

Please note the membership on the Stoneville Youth Council demands strict attendance. One meeting per month from September 2023 to May 2024.

Email *

Name of Student: *

Mailing Address: *

Email Address *

Primary Phone Number: *

Secondary Phone Number:

Date of Birth: *

YYYY

Gender: *

Male

Female

School: *

Current Grade: *

Parent or Guardian: *

Parent/Guardian Email Address: *

Please check all that apply: *

I will have transportation to get to Youth Council meetings and/or events

I will need transportation to get to Youth Council meetings and/or events

If I become a Youth Council member, I will try to attend all meetings and functions

I initiated my own interest in this program

Required

If asked to apply for this program - by whom? Name/Position/Organization

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