City of Temple Terrace Customer Service

Mayor's Youth Leadership Application

3. 

6. Mayor's Youth Leadership Council

8. First Name

9. Last Name

11. Address

13. City

14. State

15. Zip

17. Age

18. School

19. Grade

21. GPA

22. Home Telephone

23. Student Cell Phone

25. Student Email

27. Parent Guardian:

29. First Name

30. Last Name

32. Phone Number

33. Email

35. *Include work and cell phones for parent/guardian.

37. Work Experience Please list any job/work experience:

39. Are you currently employed/where?

40. How many hours a week?

42. Required Short Essay: If you could develop a plan and work to positively impact a community issue, on what would you choose to focus? Limit your response to 500 words. Use a separate sheet of paper if needed and submit it with your application.

44. References PDF
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46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

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