Fillable Charleston Youth Council - Fillable

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Charleston Youth Council - Fillable

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Page 1
CHARLESTON YOUTH COUNCIL APPLICATION
Office of Mayor Amy Shuler Goodwin
501 Virginia Street, East, Charleston, WV 25301
Applications for the inaugural Charleston Youth Council are due by close of business FRIDAY,
SEPTEMBER 20, 2019. Applications must include parent/guardian signature.
For questions regarding the application or the Charleston Youth Council, please call 304-348-8000
ext. 116 or email mayorsoffice@cityofcharleston.org.
CONTACT INFORMATION
*Please type or print legibly
Name:
Address:
City, State, Zip Code:
Cell Phone:
OK to receive texts: YES NO
Home Phone:
Email Address:
Date of Birth:
Name of School:
Grade (2019/2020 School Year):
Page 2
SHORT ANSWER QUESTIONS
*Please respond to the following questions in one of the following ways. (1.) Type or write your responses
below. More space is available on the last page. (2.) Upload your video response with the title: Charleston
Youth Council Application: [Name] and provide the web link below.
☐
I am providing a video response:
1. What do you think are the best things Charleston has to offer our youth?
2. Where do you think the City can do better in providing for the youth of Charleston?
3. Why do you want to serve on the Charleston Youth Council?
4. Tell us about yourself—for example interests, community/organization involvement, etc.
5. Tell us about an idea that you have that would encourage young people to spend time in
Charleston or an idea that would improve the quality of life for young people in Charleston.
Page 3
REFERENCES
*please provide at least 2 references and 1 letter of reference
Name:
Affiliation/Relationship:
Phone:
Email:
Name:
Affiliation/Relationship:
Phone:
Email:
Name:
Affiliation/Relationship:
Phone:
Email:
Name:
Affiliation/Relationship:
Phone:
Email:
Page 4
SIGNATURES
*Please sign and date below. A parent/guardian signature is required.
Applicant Signature: Date:
Parent/Guardian Signature: Date:
Phone:
Email:
Mail completed application and letter(s) of reference to:
Mayor Goodwin’s Office
Attn: Tina Stinson
501 Virginia Street, East
City Hall, 2
nd
Floor
Charleston, WV 25301
All applications, including 1 letter of reference, must be postmarked by Friday, September 20,
2019.
Page 5
If necessary, please use the space below for the short answer questions:
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Completed 11 July 2020

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