Glendale AZ - Mayor's Youth Advisory Commission Membership Application Form

Application For Membership - Mayor's Youth Advisory Commission
Student's Name*

First NameLast Name
E-mail*
example@example.com
Phone #:*
Your address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Parent/ Guardian E-mail*
example@example.com
Parent/Guardian Daytime Phone #:*
Student's Birth Date:*

MonthDayYear
Grade for school year?*
Name of School*
Applicant must be a Glendale resident, attend a Glendale school or be homeschooled in Glendale.
How did you hear about us?*

Friend or ClassmateTeacher/School OfficialSchool AnnouncementRecruitment LetterMayor's NewsletterCity of Glendale WebpageNews ArticleSocial MediaOther
Have you previously served on MYAC?*

YesNo
Is yes, when?

2022-20232023-2024
Glendale City Council District*
Find your District: www.GlendaleAZ.com/your_government/city_council/district_boundaries
List the names of any siblings who have participated in MYAC:
Unisex T-Shirt Size*

SmallMediumLargeX Large2X Large
Membership Questionnaire:
List any clubs, organizations or groups of which you are currently a member;*
Include extracurricular activities and any offices or positions of leadership you now hold or have held; list any awards received or significant accomplishments.
Why are you interested in being a member of MYAC? (250-300 words)*

0/300
Recommendation Form:

One (1) adult recommendation is required per application. This can be a teacher, mentor, boss, coach, pastor, or any other person who can vouch for the student's character, potential, and abilities. Click and/or share the link to the form below:
Recommendation Form

(Minimum of 1)
Expectations and Requirements:

(Please read and acknowledge)
If I become a member of MYAC, I understand that to remain in good standing with MYAC I will complete a MINIMUM of 20 community service hours by May 30, 2025 at 11:59 PM.*

I understand
If I become a member of MYAC, I understand that I am responsible for submitting my service hours and service photos for credit in a timely manner and no later than May 30, 2025 at 11:59 PM.*

I understand
If I become a member of MYAC, I understand that I can not have more than one (1) unexcused or two (2) excused absences from monthly meetings from August to April.*

I understand
Additional Bylaws will be provided upon acceptance into MYAC.*

I have read, understand, and accept the expectations and requirements listed above for MYAC membership.
Digital Signature of my Parent/Guardian agreeing to application expectations and requirements listed (above): *
Parent/Guardian must type/enter their own name
Should be Empty:

Application For Membership - Mayor's Youth Advisory Commission

Membership Questionnaire:

Recommendation Form:

Expectations and Requirements: