Mid-City CAN's Youth Council

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to Mid-City CAN's Youth Council! We are so excited that you are considering joining our youth council. Youth Council envisions a world where youth have the ability to participate in decision making spaces and create change in their local communities.

WHAT: Youth Council Meetings
WHEN: Fridays 4:00-6:00pm
WHERE: Hybrid: Zoom/In-person

***Youth Council is only OPEN for young people ages 13-18 that reside in San Diego County***

You can reach this form by visiting: bit.ly/JoinYouthCouncil

Youth Council in Action

First Name *

Last Name *

What is your Phone #? *

What is your most checked email? *

What is your preferred method of communication? (Choose all that apply) *

Text

Phone call

Required

Date of Birth *

YYYY

What are your preferred pronouns?

School Attending Fall of 2021 *

Grade in Fall 2021 *

Home Address *

Do you need transportation? *

Yes

Maybe

Are you vaccinated? *

Yes

If no to the question above, can we contact you to support you in scheduling a vaccine appointment?

Yes

Clear selection

Any allergies/ dietary restrictions? If no put N/A *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms