Ossining Youth Council Application

Please review the Ossining Youth Council (OYC) FAQS (click here). The FAQs provide information on the expectations and role of an Ossining Youth Council member. The submission of this application confirms you agree and will work to meet those expectations.

In addition to submitting this application, a completed Photo Release Consent Form is required as well (click here). If you are under the age of 18, a parent or guardian's signature is required. Please return the Photo Release Form via email to Chima Monday, Youth Bureau Director, at cmonday@villageofossining.org. There will be times when the OYC will be carrying out community outreach, activities, etc., and we will share the work of the OYC with the community.

Name *

Date of Birth *

Month

Day

Year

Street Address *

City, State Zip *

Email *

Phone number *

Parent/Guardian Name *

Parent/Guardian Email *

Parent/Guardian Phone *

What school do you attend? *

Ossining High School (OHS)

Anne M. Dorner Middle School (AMD)

Other

If "Other" please specify

Who is your Guidance Counselor? *

Are you currently, or have you ever been involved in other committees or councils? *

Yes

Please share why you want to be a part of the OYC. *

Date of Submission *

Month

Day

Year

Leave this field blank

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Ossining Youth Council Application