Youth Council Nomination Form
We are thrilled that you are interested in serving on the 20th District Youth Council. As your State Senator, I am deeply committed to shared governance and seek your partnership to ensure that your perspective is included in policy making and that we are centering the voices and perspectives of individuals who live in the 20th district. Additionally, I am invested in your leadership journey and hope that you are able to both gain from this experience and contribute to making our government more people and planet centered.  

The information you provide will be helpful for our selection committee to assemble a Youth Council that reflects the dynamic and rich diversity and talent in the 20th district. All Youth Council members that participate in meetings will receive a $500 stipend at the end of the five sessions.

Before you fill out this form, please confirm that your home address is within the 20th Senate district to ensure you can participate. Visit this website and enter your home address: https://elections.il.gov/ElectionOperations/DistrictLocator/AddressFinder.aspx.

If you live within the district, please confirm that you can commit to participating in Youth Council meetings on the following dates:  5/7 (10am-3pm), 5/21 (10am-3pm), 6/4 (10am-3pm),  6/11 (10am-12:30pm) and 6/10 (5:30-7:30pm).

If yes to both questions, please take your time to fill this nomination form completely by Friday, April 22, 2022. Youth Council members will be notified if they have been selected by Wednesday, April 27, 2022.
Sign in to Google to save your progress. Learn more
What is your first name? *
What is your last name? *
What are your gender pronouns in use (example: he/him/his, she/her/hers, them/they etc.) *
Required
Please enter an email address you check regularly *
Please enter your birthday using the format of DD/MM/YYYY (example: 04/15/2001) *
What is your race/ethnicity? Select all that apply. *
Required
What is your home address? (i.e. 3140 W. Montrose, 60618)
Please enter your cell phone number (enter N/A if you do not have a cell phone number) *
Which social media platforms do you use? Select all that apply. *
Required
What is the best way to contact you (check all that apply)? *
Required
Please provide the name of the high school you attend below: *
Please provide the first and last name of a parent or guardian *
Please provide a phone number where we can reach a parent or guardian *
Please provide an email address for us to use to contact a parent or guardian *
Are you able to commit to attending Youth Council meetings in person (if public health conditions permit) at 3140 W. Montrose on the following dates: 5/7 (10am-3pm), 5/21 (10am-3pm), 6/4 (10am-3pm),  6/11 (10am-12:30pm) and 6/10 (5:30-7:30pm). *
What motivates you to seek nomination for the 20th District Youth Council? (150 words or less) *
Do you participate in any other activities (ex: sports, extracurricular school clubs, college and career readiness programs, mentoring, hobbies, religious activities etc.)? If so, please explain. *
Have you been involved in policy, advocacy or community work? If so, please explain. *
What do you hope to get out of participating in the 20th District Youth Council? (150 words or less) *
If there is any additional information you want to provide us to give us further insight into you and your background, please share it here:
If you have any questions or comments for us, please share them here:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms