Salisbury Citizen"s Academy Application

Salisbury Citizen's Academy Application

Class size is limited, and preference will be given to City of Salisbury residents. Citizens who are selected to attend the School of Government must attend at least 8 of the 10 sessions in order to qualify for graduation. Applications must be received by July 31, 2018 to be eligible for consideration.

Primary Contact Information

First Name *

Last Name *

Address *

Address (Line 2)

City *

State *

ZIP Code *

Day Phone *

Evening Phone

E-mail *

Mailing Address (if different)

How long have you lived in Salisbury?

Occupation

Age *

Under 20 20-29 30-39 40-49 50-59 60-69 70 and up

Sex *

Female Male

T-shirt Size *

Small Medium Large X-Large XX-Large

Please share any previous experiences working with the City of Salisbury (serving on a Board or Commission, volunteering, etc.): *

Please share any previous experiences working with government apart from the City of Salisbury, including any other localities or states: *

What areas of City government are of particular interest to you? *

Please explain why you are interested in attending the Salisbury Citizen"s Academy: *

How did you hear about the Citizen's Academy? *

By signing below, I affirm my intent to attend all 10 sessions and attest that I have not been convicted of a crime that would make me ineligible for participation. If applicant is under the age of 18 the application must be signed by parent or legal guardian.

I further agree to give the City of Salisbury permission to use my name, photo, or quotes for promotion or other publicity for Salisbury Citizens Academy and other City-sponsored projects.