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Returning Youth ApplicationApplications Due Tuesday, January 8, 2019 @ 11:59pm

Submitter Information

Full Name

Address

What grade are you in currently?

Parent / Guardian Contact Information

Full Name

Address

Would you like to add another parent / guardian?

Full Name

Address

Please answer the following questions to the best of your ability.

During the six week summer program you are required to work five days a week from 7am-1pm from June 17 - August 2. By checking the box below, I understand and accept the ROLES AND RESPONSIBILITES of the Returning Youth listed HERE.

Have you participated in other City Sponsored programs?

By signing below, I certify that all information in my application is true, complete, and correct. I also agree that I have read and understand the roles and responsibilities of being a Returning Youth for the 2019 Summer @ City Hall Program.

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Signature

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