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2021-2022 Genesee County Citizenship Academy
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First Name
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Last Name
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Street Address
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City
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Zip Code
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Telephone number
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Email
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Birthdate
MM
/
DD
/
YYYY
Grade
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High School
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Race/Ethnicity (check all that apply)
American Indian/Alaskan Native
Asian
Black/African American
Caucasian/White
Hispanic/Latinx
What is your gender?
Your answer
Who is your Genesee County Commissioner? (see
https://www.gc4me.com/departments/gis/docs/2012_Political_District_Mapbook.pdf
)
Choose
District 1 - Bryant W. Nolden
District 2 - Charles H. Winfrey
District 3 - Ellen Ellenburg
District 4 - Domonique Clemons
District 5 - Mark Young
District 6 - Shaun Shumaker
District 7 - Meredith Davis
District 8 - Debra Newman
District 9 - Gary Peppin
Our community and decision makers are facing community issues everyday. We want to hear from a youth perspective, what are some of the most important issues you see for Genesee County today?
Your answer
Why are you interested in being part of this commission?
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This group will meet on a monthly basis. Are you able to commit to a monthly meeting? How will you make accommodations in your schedule to attend these meetings?
Your answer
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