Eureka Youth Council

2. Today's Date
   Today's Date

   Today's Date
3. Youth Council Program Overview
   Youth Council Program Overview (PDF)

5. Deadline to apply to Eureka Youth Council 2023/2024 term is Friday, May 26, 2023.

7. Applicant First & Last Name*
8. Parent/Guardian First & Last Name*
10. Parent/Guardian Best Contact Phone Number*
11. Home, Work or Cell?*
    -- Select One --HomeWorkCell
13. Best Contact Email Address*
14. Mailing Address *

16. Qualifications

18. Current Grade Level*
    -- Select One --789101112
19. School of Attendance*
21. Questions

    Please try to answer the following questions in complete sentences and tot eh best of your ability with short but well-thought-out answers. NOTE: The City of Eureka does not require any prior government related classes or knowledge - applications for this program are open to all who meet the basic geographical location and age requirements. Good luck and thank you for applying to be a member of the Eureka Youth Council 2023/2024.

23. 1. What makes you interested in serving on Eureka Youth Council 2023/2024?*
25. 2. What do you cherish and appreciate the most about Eureka? Why?*
27. 3. Name something you would like to see changed or initiated in Eureka that you believe would benefit Eureka's youth. Why do you think this?*
29. 4. How would you approach making that change or starting that initiative?*
31. 5. Name qualities, characteristics, and/or skills that you think make you a good candidate for Eureka Youth Council 2023/2024.*

33. Commitment

35. Are you able to commit to the Youth Council schedule?*
    -- Select One --YesNo
36. Youth Council Calendar
    Youth Council 2023/2024 Calendar (PDF)
38. If not, it’s okay. Just please explain what days/times you would need to be absent and why.
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field

2. Today's Date
   Today's Date

   Today's Date
4. Teacher First & Last Name*
5. Area of Study/Class*
7. Teacher Contact Phone*
8. Teacher Contact Email*
10. Name of the Student that this reference is for.*
12. In a few words, what comes to mind when you think of this student?*
14. In your opinion, what makes this student fit for being selected as an Eureka Youth Council member?*
16. What are the student's strongest attributes and what has caused you to formulate that decision?*
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field