Smithfield City Youth Council Application

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Applicants must be in 10th-12th grade. Smithfield City Youth Council (SCYC) membership term is one year beginning August 1-May 31. Applications must be completed by May 1. Interviews will be set up shortly after the application deadline. First time applicants must bring 2 letters of recommendation to their interview. Returning applicants do not need letters of recommendations and are eligible to apply to be on the Executive Board. *If you are a returning SCYC member and want to be on the Executive Board, please also complete the leadership application in Section 2 of this Application.

Applications for 2021-22 Smithfield City Youth Council Members will be accepted until May 1, 2021

Please complete online form to be considered for council membership.

First Name *

Last Name *

2021-22 School Year Grade or Equivalent *

10th

11th

12th

Home Phone # (If no home phone # is available, please enter 0) *

Cell Phone # (If no cell # is available, please enter 0) *

Do you receive text messages at this cell #? *

Yes

Home Address *

Email Address (Cannot Use School Email Address) * *

Shirt Size (Adult Sizes) *

XXL

Extra Curricular Activities *

Special Achievements *

The following are requirements to serve on the Smithfield City Youth Council: Read and then check each box to show your agreement. *

You must be, and remain, a resident of Smithfield City, or reside in outlying unincorporated areas around Smithfield.

You must have no failing grades in school.

If you have 4 unexcused absences from Youth Council Meetings or Activities (haven't contacte a YC Advisor or Exective Council Member) for both activities and meetings, you will be released from the youth council.

You must fulfill the responsibilities of the office held.

You must set a proper example for the youth of the community.

Required

Signature of Applicant (electronic signature) *

Parent(s)/Guardian Name *

Parent's email address *

Mother's Cell # *

Father's Cell #

Signature of Parent (electronic signature) *

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