HIGH POINT 101 ACADEMY APPLICATION
Personal Information
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Demographic Information
Gender Identity
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Are you currently a resident of the City of High Point?
Yes
No
How long have you lived in High Point?
Less than 1 year
1-5 years
6-10 years
More than 10 years
Employer
Job Title / Occupation
Civic Engagement Questions / Community Involvement
Please describe any community organizations, volunteer activities, or civic groups you are currently involved in.
Why are you interested in participating in the High Point 101 program?
How do you plan to use the information gained from this program to benefit your community?
Are you interested in serving on a City of High Point board or commission?
Yes
No
Maybe / I'd like more information
Optional upload to supplemental documents further outlining your interests in participating in High Point 101 or your interest in serving on a board or commission
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Program Commitment
High Point 101 participants are expected to attend most program sessions. Sessions are generally held during the evening hours and may include occasional Saturday activities. Are you able to attend evening sessions?
Yes
No
Are you able to attend occasional Saturday sessions?
Yes
No
Attendance Commitment
*
"I understand and agree to the attendance expectations of the High Point 101 program."
Signature
Date
-
Month
-
Day
Year
Date
How did you hear about HP101?
City of High Point website
City of High Point social media
Neighborhood Association
City Employee
Email Announcement
Flyer
Media Coverage
Previous HP101 participant
Community Event
Other
Submit
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