Citizens Government Academy Application

Last Name

 *

Enter last name

First Name

 *

Enter first name

Middle Name

Enter middle name

Previous Names Used (including maiden name)

Previous names used

Street Address

 *

Enter street address

Zip Code

Enter zip code

Primary Phone

 *

Enter phone numberext.

Email

 *

Enter email address

Date of Birth

 *

Enter Date of Birth

How long have you lived in Moorhead

 *

How long you have lived in Moorhead?

On a scale of 1-10, how well do you believe you understand the functions of a municipal government? (10 meaning you should be the City Manager!)

1
2
3
4
5
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7
8
9
10

Have you ever attended a City Council meeting? Why?

Have you ever attended a City Council meeting?

Why are you interested in Citizens Government Academy, and what do you most hope to learn?

Why are you interested in Citizens Government Academy?

Do you have any dietary restrictions?

Do you have any dietary restrictions?

Shirt Size

 *

Woman's S

Woman's M

Woman's L

Woman's XL

Men's S

Men's M

Men's L

Men's XL

Other

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