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Youth Engagement Committee Member Application Form

Personal Information

Last Name

First Name

Street Number and Name

City/ Town

Province

Postal Code

Home Phone #:

Cell Phone #:

Email Address

Birthday

School:

Fall 2021 Grade:

Please check box

I am between the ages of 12 and 17

I have attached a letter of interest

Letter of Interest

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Emergency Contact Name

Relation to Applicant

Contact Number

Previous Related Volunteer/Work Experience

Please begin with the most recent

1. Organization

From (MM/dd/yyyy)

To (MM/dd/yyyy)

Position Held

2. Organization

From (MM/dd/yyyy)

To (MM/dd/yyyy)

Position Held

3. Organization

From (MM/dd/yyyy)

To (MM/dd/yyyy)

Position Held

Other related experience (hobbies, outside activities, courses, workshops, leadership courses, etc.)

I, the undersigned, certify that all information contained within this application is truthful and accurate.

Clear

Date (MM/dd/yyyy)

Signature (Parent/Guardian)

Since the applicant is under the age of 18, please sign below to indicate your approval of their involvement with the Town of Aurora Youth Engagement Committee.

Name

Relationship to Applicant:

Date (MM/dd/yyyy)

Applications will be accepted until July 31, 2022.

Please note that by providing your e-mail address, you are consenting to receive future correspondence (promotional or otherwise) from the Town of Aurora, Parks, Recreation, and Cultural Services Department. All information in this application will be kept confidential.