Mayor's Community

Council Application

First Name *

Last Name *

Address

Street Address *

City *

State *

Country

Postal Code *

Phone *

Email *

Why do you wish to participate in the Community Council?*

Please give the name, address, phone number, and email of two character references:

Reference #1: *

Reference #2: *

Emergency Contact: *

I understand that applicants are required to be at least 18 years of age and a simple background check will be completed prior to the program beginning. I will be available to attend meetings the 3rd Friday of the month from 11:00 a.m. – 1:00 p.m through the calendar year of 2026. Attendance is required to earn a certificate at the end of the program. The program is scheduled to end on December 8, 2026. *

Yes

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