West Vancouver - Sunshine Coast - Sea to Sky Country Youth Council Application 2018/19
Please submit your application by October 15, 2018 to be considered for MP Pamela Goldsmith-Jones' Youth Council, if you are 15 - 18 years old and live or go to school in our riding.

If you have questions, please contact our office at pam.goldsmith-jones.c1a@parl.gc.ca or 604-913-2660.

Our 2018/19 Youth Council with Minister Marc Garneau
Full Name: *
Your answer
Birth date: *
MM
/
DD
/
YYYY
Gender:
(*optional*)
Address: *
(*please include your postal code*)
Your answer
Phone number: *
Your answer
Email: *
Your answer
Are you a returning member of CYC? *
Do you identify as a member of an under-represented community? Please specify which community.
(*optional*)
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Liberal Research Bureau. Report Abuse - Terms of Service - Additional Terms