EmailMe Form - Mt. Pleasant Youth City Council Application

Name *
First Last
Cell Phone
### - ### - ####
Home Phone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Facebook Address (Please add the Mt. Pleasant YCC page as a friend)
Birthdate *
MM / DD / YYYY
Grade *
GPA *
If you have a job, how many hours do you work per week?
Emergency Contact *
First Last
Emergency Contact Phone Number *
### - ### - ####
Which positions do you aspire to hold on the YCC?(Check all that apply) *
Mayor
Pro-Tem Mayor
Recorder
Treasurer
Council Member (8)
Questions or Comments
Examples of past events include:

*4th of July "Kids" Games
*Christmas Shopping for "Needy" Families
*Trip to the Capitol for Legislative Day
*Judging the "Ugly Truck Contest"
*Dances
*Easter Egg Hunt
*Leadership Conference
*Various Fun Raisers
Parent or Guardian Agreement *
Applicants must be between the ages of 14 and 18 and live within the boundaries of Mount Pleasant for consideration of membership. By submitting this form you agree that the By-Laws have been read, understood, and agree to let your child participate.
Parent or Guardian Electronic Singiture *
First Last