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Membership Application - Under 18 Questions
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* Indicates required question
Email address (of youth applicant, if possible)
Your answer
First Name
*
Your answer
Middle Name or Initial
Your answer
Last Name
*
Your answer
County where you live
*
Choose
Allegany
Anne Arundel
Baltimore County
Baltimore City
Calvert
Caroline
Carroll
Cecil
Charles
Dorchester
Frederick
Garrett
Harford
Howard
Kent
Montgomery
Prince George's
Queen Anne's
Saint Mary's
Somerset
Talbot
Washington
Wicomico
Worchester
Please share your pronouns. Pronouns are the part of speech used to refer to someone in the third person. We want to know how to respectfully refer to you!
*
She/Her/Hers
He/Him/His
They/Them/Theirs
Ze/Hir/Hirs
Other:
Parent or guardian name
*
Your answer
Parent or guardian email
*
Your answer
Parent or guardian phone
*
Your answer
I give permission for the minor to complete this form and to take part in the Maryland Civic Education Coalition.
*
Yes
No
Grade Level
*
Your answer
School Name
*
Your answer
If you are part of an extracurricular program or youth group, what is name of your organization?
Your answer
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