Your Name (required)
Birthday
School
Grade
Neighbourhood
Phone Number
Email
What community and/or school groups are you currently involved in?
What life experiences have inspired you towards leadership and advocacy for youth in Chilliwack?
If you were given the opportunity to advocate for youth in the City of Chilliwack, what subjects would be your top 3 priorities?
Are you able to commit an average of 2-3 hours a week to this program? YesNo
Are you available for an in-person interview between September 16-26? YesNo
