City Council Page Application Request Form

The Jacksonville City Council Page Program seeks to give youth between the ages of 12 through 18 the opportunity to learn about the inner workings of local government and gain valuable experience. The Pages will work before and during a City Council meeting and help with tasks assigned by the Legislative Services Division.

Please fill out the form below to have a youth participate in the City Council Page Program. For any questions, please contact PageProgram@coj.net. Please note that an Adult/Guardian/Parent is required to accompany the youth participant to the Council meeting.

Name of School or Organization Affiliation:

Contact Name:

Contact Phone Number:

Contact Email:

Student's First and Last Name:

Student's Contact Number:

Calendar:

Today

Grade Level of Student:

Photo Approval:

No
Yes

(Special requests, accommodations needed, medical needs or allergies, etc.):

Additional Notes:

Acknowledgment that an Adult/Parent/Guardian is required to accompany the participant to the Council meeting and remain until the conclusion of participation. The Page is requested to participate in the program from 4:30 pm to 6:30 pm.

Initials:

CAPTCHA:

City of Jacksonville

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