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2024 Eatonton Youth Leadership Participant Application
PLEASE SUBMIT THIS FORM ON OR BEFORE FRIDAY, JANUARY 26, 2024
For more information, please contact:
City Administrator Gary Sanders
(706) 485-3311
gsanders@eatontonga.us
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* Indicates required question
Name:
*
Your answer
Address:
*
Your answer
Telephone Number:
*
Your answer
Email Address:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
I reside in the following City Ward:
*
Ward 1
Ward 2
Ward 3
Ward 4
I do not reside within the City limits
I am a student at:
*
Putnam County Charter School
Gatewood
Home School (within Putnam County)
Other:
I am in the following grade:
*
11th
12th
What personal characteristics/qualities do you possess that enable you to be and/or create a good leader and peer role model?
*
Your answer
What do you hope to learn or achieve from the Eatonton Youth Leadership Program?
*
Your answer
My t-shirt/sweatshirt size is:
*
XS
S
M
L
XL
XXL
XXXL
Other:
I commit to attend the scheduled monthly meetings of Eatonton Youth Leadership, with two excused absences permitted.
*
Yes (required for program participation)
No
I commit to completing 10 hours of community service during the program year.
*
Yes (required for program participation)
No
I give the City of Eatonton permission to use my photo and any written statement that I have made regarding the Eatonton Youth Leadership Program for the sole purpose of advertising and promoting Eatonton Youth Leadership:
*
Yes (required for program participation)
No
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