Youth Commission Application If you are human, leave this field blank. GENERAL INFORMATION Last Name * First Name * Middle Name * Phone * Email * Clayton County Resident * Yes No School * Grade Fall 2020-2021 * 9th 10th 11th 12th Home Address * Home Address Home Address Home Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Gender * Female Male Race * Birth Date * T-Shirt Size * Parent/Guardian Name * Best Contact Number * Parent/Guardian E-mail Address * Alternate Contact Name Alternate Contact Number Alternate E-mail Address How did you learn about the Clayton County Youth Commission? * Using a few phrases or adjectives, describe yourself. * SCHOOL EXPERIENCE Other schools attended besides current school: * List up to 3 special awards, honors or recognitions for academic, extra-curricular, sports, school or community related activities you have received from rising 9th grade to the present. * What are your main areas of interest in school? * WORK EXPERIENCE Do you currently have a part-time job? * Yes No How many hours per week? * Would your job interfere with your participation on the Youth Commission? * Yes No List any part-time job experiences, paid or volunteer, and briefly tell what it involved. * Do you have any extracurricular activities that will interfere with attending meetings/special events/service projects? * ORGANIZATIONS AND ACTIVITIES List in order of importance to you up to five school, volunteer, religious, social, athletic or other activities or organizations in which you participated during the last 2 years. Organization/Activity Leadership Responsibility/Involvement Grade in School 1. 2 Dropdown Rising 9th 9th 10th 11th 12th 1. 2 Dropdown Rising 9th 9th 10th 11th 12th 1. 2 Dropdown Rising 9th 9th 10th 11th 12th 1. 2 Dropdown Rising 9th 9th 10th 11th 12th FOR RETURNING YOUTH COMMISSION MEMBERS ONLY: PLEASE INDICATE THE TOTAL NUMBER OF YEARS YOU HAVE SERVED ON THE COMMISION Type a 250-word essay in response to the following question. What do you feel you contributed to the 2019-2020 Clayton County Youth Commission and why you would like to serve again, what did you learn from and how will you contribute differently in the upcoming year?(If you did not participate last year please type N/A) COMMUNITY AWARENESS Type a 250-word essay in response to the following question. What do you think are the 3 most important issues facing Clayton County youth today and what are your suggestions in dealing with these issues? * Letters of Recommendation The Youth Commission requires TWO (2) letters of recommendation. Letters of recommendation should be from an elected official, your principal/headmaster, guidance, counselor, teacher, a coach, and/or community leader. If you already have your letters of recommendation attach them here. File Upload Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 67.11MB File Upload Drop a file here or click to upload Choose File Maximum upload size: 67.11MB If you do not have your letters of recommendation available now, you may enter two email addresses below. These should be the email addresses of the two individuals who will be providing your letters of recommendation. They will be sent an email that will have instructions on how to provide the letter to the Office of the Youth Commission. Leave this blank if you uploaded your letters already or you plan to bring them in person. Email 1 Email 2 Letters of Recommendation are REQUIRED. If you chose the email option please follow up with your chosen individuals to make sure the letters are sent. If you have not spoken to anyone yet about letters of recommendation please do so and bring your letters with you for the interview. PARENTAL PERMISSION FORM Dear Parent/Legal Guardian: By applying for The Clayton County Youth Commission, your child is making a commitment to take part in an outstanding leadership development and youth service program. This form is to verify that you are aware of the attendance policy & program requirements. Upon selection to participate on The Clayton County Youth Commission, students are expected to attend all program activities. Please sign & return this form with the application. The above dates & requirements are further detailed on the enclosed information sheet which you may keep as a reference. You are responsible for reading them in full before signing this permission form. Information provided on this application form will be reviewed in confidence. All applicants selected to serve on the Youth Commission will be notified in writing. I have read & understand the program requirements, including the attendance policy. My son/daughter has my support & permission to participate on the 2018-19 Clayton County Youth Commission. Parent/Guardian Signature * Clear Date * ATTENDANCE POLICY Youth Commission members must attend all specified meetings, activities, programs, and special events sponsored by the Office of Youth Services. Youth Commission membership can be terminated in writing at any time by the Office of Youth Services or a Youth Commissioner. If you cannot attend a meeting or event, the Office of Youth Services must be notified in writing at least 24 hours prior to the event. A combination of three (3) missed assignments and/or unexcused absences during your youth commission term will result in termination from the Commission. Absences due to extenuating circumstances (i.e. death in the family, illness) may be excused. The Orientation Session is mandatory for parents and youth commission candidates. Failure to attend for any reason other than illness, serious accident or death in the family, will result in disqualification from the program. Dates will be provided in the acceptance letter I attest that all information provided is correct. I have read and understand the Clayton County Youth Commission requirements, and if selected, will meet them. Applicant Signature * Clear Date * Submit
