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NCDM Youth & Government Application
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Background Information
First Name
Your answer
Last Name
Your answer
Grade
9th
10th
11th
12th
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Gender
Female
Male
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Email Address
Your answer
Cell Phone Number
Your answer
Parent First Name
Your answer
Parent Last Name
Your answer
Parent Email Address
Your answer
Parent Cell Phone Number
Your answer
Have you tried our for Y&G before?
Yes
No
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Have you confirmed you can make all three conferences and have no conflicts with Wednesday meetings? (These are mandatory for inclusion in the program)
Yes
No
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In 100 words or less, name a teacher/coach and tell us what they would say about you.
Your answer
Please describe any relevant political and/or civic experience or aspirations you have. (Prior experience is NOT a requirement for Y&G, so don't worry.)
Your answer
What was your favorite part of the Info Meeting, and why?
Your answer
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