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Youth on a Mission Application

  1. Youth on a Mission (YAM)

    The application deadline is October 14, 2019. For more information on YAM, please contact Council Member Chemberly Cummings at or visit

  2. Tell Us about Yourself

  3. Current Grade Level

  4. Languages Fluently Spoken

  5. If Applicable

  6. Race/Ethnicity

    check all that apply

  7. Gender

  8. Please respond to the following questions in 200-350 words.

  9. The letter must be signed and include name of person, position, email address, and phone number.

  10. By my electronic signature, I certify that the above answers are true.

  11. By my electronic signature, I certify that I am the parent/guardian of the applicant, and the applicant has my permission to submit this application and participate in in the YAM program.

  12. Leave This Blank:

  13. This field is not part of the form submission.