Youth Ambassador 2026 Application
Name:
*
First Name
Last Name
School
*
Amistad High School
Cathedral City High School
Coachella Valley High School
Desert Chapel High School
Desert Christian Academy
Desert Hot Springs High School
Edward Wenzlaff
Desert Mirage High School
Homeschool
Horizon/Summit School
Indio High School
La Familia Continuation
La Quinta High School
Mirus Secondary School
Mount San Jacinto Continuation
Palm Desert High School
Palm Springs High School
Palm Valley School
Rancho Mirage High School
Shadow Hills High School
West Shores
Xavier College Prep
Choose your grade for 2025 - 2026 school year
*
Freshman
Sophomore
Junior
Senior
GPA:
*
Cell Phone Number:
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State
Zip code
Email Address:
*
Please describe why you’re interested in serving as a Youth Ambassador. Make it personal. Tell us about you, your family and your school.
*
300 word limit
0/300
What experience or skills can you offer to the program?
*
0/300
Have you attended Youth Town Hall? If so, tell us about your experience.
*
0/300
Give us one interesting fact about yourself.
0/50
Please provide a teacher reference. All references will be contacted for recommendation into the program.
Teacher Name:
*
Subject taught:
*
Teacher Email:
*
example@example.com
How did you hear about the Youth Ambassador opportunity?
Youth Town Hall Event
Youth Ambassador
Teacher/Counselor
Other
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