Elected Official for the Day

Elected Official for the Day
Submission Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Choose elected official you would like to meet with
The Mayor's schedule is currently full. Please check back monthly for future availability.
Name of Student

First NameLast Name
Name of Student's School
Grade Level
Name of Student's School
Write Homeschool, if applicable.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Home Address

Street Address

(Apt. / Suite)

CityState

Zip Code
Parent/Guardian Email Address
Parent/Guardian Phone Number
Format: 000-000-0000.
In your child’s own words, why do they want to be the “Elected Official for the Day” and what do they hope to learn about our city government?

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By typing my name in the below space, I am electronically signing this form. By signing this electronic signature certifies the information to be true, accurate, and complete.

First NameLast Name
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