2. Personal Info
4. First Name:*
5. Last Name:*
7. Phone:*
8. Text Availability:*

   1. Yes
   2. No
9. Email:*
11. Address:*
13. City:*
14. State:*
15. Zip Code:*
17. Date of Birth:*
    Date of Birth:
19. Parents' or Guardians' Names:*
20. Parents' or Guardians' Phone:*
22. Parents' or Guardians' Email:*
24. School Info:
26. School Name (must be a Jonesboro area school):*
27. Grade Level for Upcoming School Year (must be at least 10th grade):*
29. Current Grade Point Average*
30. Graduation Year:*
32. References:
    Each applicant must have (at least) one school reference and (at least) one community reference, all of which must be adults that are non-relatives, and do not live in your home.
34. Name:*
35. Phone:*
36. Email:*
38. Name:*
39. Phone:*
40. Email:*
42. UPLOAD 2 LETTERS OF RECOMMENDATION IN PDF FORMAT

    *SAVE WORD or PAGES DOCUMENT as a PDF copy in the software itself, then upload it.

44. Recommendation Letter 1*
    PDF Format ONLY
46. Recommendation Letter 2*
    PDF Format ONLY
48. Interests and Future Plans
50. 1. List your current obligations, interests and activities (job, hobbies, organizations, clubs, sports, positions held).*
52. 2. What are a couple of issues you would like to see addressed in our community which are important to you, your friends, and your family?*
54. 3. Why do you want to serve on the MYAC?*
56. 4. How do you think the MYAC can best represent the youth of our community?*
58. 5. What personal skills and characteristics do you possess that would make you a good member of this council?*
60. 6. Have you volunteered before? If so, please tell us where and what you did.*
62. 7. Are you willing, committed and available to attend the regularly scheduled MYAC meetings once a month, as well as service events?*
64. 8. Do you have time and the desire to serve on volunteer community projects and/or special committee projects throughout the school year? *
66. 9. What are your post high school plans? *
68. Signature:*
    By signing I agree that all information submitted is correct and my parent or guardian has given consent for application and to potentially serve on the MYAC.
69. Date:*
    Date:
Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field