Youth Commission Application

City of Reading Youth Commission Application Form

The City of Reading Youth Commission, enacted as Bill 47-2017 amending City Code Chapter 23 by adding Part 15, will serve as an advisory body to the Mayor, City Council, and Managing Director about issues of interest to youth that pertain to youth in the City of Reading. Youth and young adults are impacted by the decisions of City officials, but they seldom have the opportunity to directly participate in the process. Establishment of a Youth Commission will facilitate the participation of youth and young adults in local government, as well as provide City officials an opportunity to hear and address their ideas and concerns.

The City of Reading is looking for 15 Reading residents between the ages of 16 - 24 to meet at least quarterly to

Interact with City and County Government leaders
Speak on behalf of Reading youth
Help local government better understand the issues facing Reading youth
Identify initiatives that will engage Reading youth
Serve as youth ambassadors for Reading
Plan community events and participate in volunteer projects

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone #

Email

Years living at this address

Date of Birth

What School Do You Attend?

What are your strong points? How will the City of Reading benefit from your membership on the Youth Commission?

Describe something you have accomplished or a project you have worked on, individually or in a group. This should be something that was important to you. How did you contribute to the achievement?

If selected as a member of the Reading Youth Commission, what one project would you like to help the Commission implement?

In your opinion, what are the three most important issues facing youth today and how do those issues affect your generation?

Have you ever been employed? If so, please list places of employment with dates.

What are your educational and career goals?

Please list all extracurricular activities (academic, athletic, political, religious, social, etc.) you are currently involved in and any you anticipate joining within the next year.

If you have any other information or experiences that would be helpful to the Mayor and City Council to consider, please list them here:

I verify that the statements made in this application are true and correct. I understand that any false statements herein are made subject to penalties of 18 PA.C.S. 4904, relating to unsworn falsification of authorities.

I authorize the City of Reading to review my tax payment record (including all applicable taxes payable to the City of Reading) and my utility payment records. I authorize each applicable agency to which this form is presented to release any results, upon request of the City of Reading, as described above. Copies of this consent that show my signature are as valid as the original signed by me. This consent is valid until the termination of my application process or my affiliation with the City of Reading, whichever is later.

I understand that prior to being considered for any Board, Authority, or Commission that has direct contact with children, as determined by City Council, I must provide (1) Pennsylvania Child Abuse History, (2) Pennsylvania State Police Criminal Records Check, and (3) Federal Bureau of Investigations (FBI) Criminal History Background Check (where requested by Council because I have not lived in Pennsylvania for at least 10 years prior to the date of this application). This background information will be evaluated by Council in accordance with the City’s Background Check Policy set forth in Resolution 180-2020. Background check forms are available for download at http://www.keepkidssafe.pa.gov/resources/clearances/index.htm or upon request from the City Clerk’s office. Background checks are free for all volunteers who have lived in the Commonwealth of Pennsylvania for at least 10 years prior to the date of the application. If you are not sure whether you have to provide a background check, please contact the City Clerk’s office.

I hereby irrevocably release and discharge each agency to which this form is presented and such agency’s representatives and agents from any and all liability of any nature whatsoever in any way arising from or relating to disclosure of information of any nature about me and I further agree to indemnify and hold harmless each such agency from any and all loss, cost, damage, expense, or liability of any nature (including, but not limited to, attorney fees and criminal penalties) incurred by such agency or its representatives and agents in association with, or as a result of disclosure of information about, me. I further agree each agency to which this form is presented and such agency’s representatives and agents are third-party beneficiaries with direct standing to enforce the release and indemnification provisions set forth herein.

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Date

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