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* 1. Your Full Name:

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* 2. What is your birthdate?

Date of birth:

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* 3. Home Street Address:

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* 4. City:

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* 5. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 6. Home Phone:

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* 7. Your Cell Phone:

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* 8. At what email address would you like to be contacted?

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* 9. At what email address would your parent(s) like to be contacted?

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* 10. Parent's cell phone:

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* 11. School: (If homeschooled, please say so)

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* 12. Grade:

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* 13. Parent Name(s):

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* 14. Why do you want to be a member of the Mayor's Youth Commission?

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* 15. What issues are important to you?

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* 16. What extracurricular activities do you participate in?

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* 17. We meet the first Thursday of every month. We have 10 meetings a year, and you must attend 8 of them.
If you do not attend at least eight MYC meetings/events, your membership will be terminated. Are you able to commit to this?

By submitting this application, you understand that you are applying to be a member of the Mayor’s Youth Commission.  Upon review, you will be contacted via e-mail regarding approval.  There will be an additional photo release document required for all approved members.
If you have any questions, please visit our website: http://www.arlington-tx.gov/myc/

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