Step 1 of 3 33% CONTACT DETAILSName* First Last Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code Phone*Email* Date of Birth* DD MM YYYY SCHOOL & GROUPSAre you a member of any of the following groups? UK Youth Parliament School/Youth Council County Hospital Young Ambassadors Uniformed Group Y-Team Community/Voluntary Group Are you a member of any groups not shown above?Which school/college do you attend?*Have you been involved with anything like a Youth Council before? If so, please tell us about it: APPLICATION When answering the following questions, think about what we are looking for and try to include this…Why do you want to be a Youth Councillor?*What skills and qualities would you bring to the role?*What do you want to achieve for Hereford's young people?*Do you have any additional needs?Electronic Signature*Date* DD MM YYYY Parent/Legal Guardian's DetailsFull Name*Electronic Signature*Date* DD MM YYYY
