2. Are you a returning member of the MYAC?

   1. Yes
   2. No
4. Personal Info
6. First Name:*
7. Last Name:*
9. Phone:*
10. Text Availability:*

    1. Yes
    2. No
11. Email:*
13. Address:*
15. City:*
16. State:*
17. Zip Code:*
19. Date of Birth:*
    Date of Birth:
21. Parents' or Guardians' Names:*
22. Parents' or Guardians' Phone:*
24. Parents' or Guardians' Email:*
26. School Info:
28. School Name (must be a Jonesboro area school):*
29. Grade Level for Upcoming School Year (must be at least 10th grade):*
31. Current Grade Point Average*
32. Graduation Year:*
34. Interests and Future Plans
36. 1. As a returning member, did you serve as a member of the Board of Directors?
38. 2. What Task Force Committee(s) did you serve on?
40. 3. Was there a project you would like to expand upon? Please explain.
42. 4. 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?*
44. 5. Why do you want to serve on the MYAC?*
46. 6. How do you think the MYAC can best represent the youth of our community?*
48. 7. What personal skills and characteristics do you possess that would make you a good member of this council?*
50. 8. Are you willing, committed and available to attend the regularly scheduled MYAC meetings once a month, as well as service events?*
52. 9. Do you have time and the desire to serve on volunteer community projects and/or special committee projects throughout the school year? *
54. 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.
55. Date:*
    Date:
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field