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Weatherford Citizen University Application
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Please complete application below for consideration to Weatherford Citizen University. Applicants must be registered voters in the City of Weatherford, a resident for at least one year, 18 years of age and not running for local political office during the 10 month program. Applicants will be notified if selected. Thank you for your interest in Weatherford Citizen University 2017.
How many years have you been a Weatherford resident?
MAILING ADDRESS IS:
Check box only if mailing address is same as physical address.
Same as physical address.
Are you a registered voter?
-- Select One --
What is your Voter ID number?
What is your occupation?
Who is your employer?
What is your Polo Size?
-- Select One --
Please complete questions below:
What activities/organizations do you participate in?
Why do you want to participate in the Weatherford Citizen University?
Identify three issues you feel are important to Weatherford and/or your key areas of interest?
This information will be provided for class presenters.
What do you see as positives for you living in Weatherford?
How did you hear about Weatherford Citizen University?
If other, please explain.
Authorizaton to Use Image
I hereby consent to my photograph being taken or image recorded by the City of Weatherford in connection with Weatherford Citizen University (WCU) regular meetings and activities. Furthermore, I authorize the use, copyright or publication of my name, image or voice as may be captured by photograph, video or audio recording while attending or participating with the Weatherford Citizen University (WCU), in any medium, for any purpose, including illustration, promotion, marketing or advertisement.
As an applicant for the 2016-17 Weatherford Citizen University (WCU), you understand the importance of being an active participant in WCU classes and activities. If selected, you agree to do the following: Attend regular classes. Contribute ideas and energy to WCU classes and activities. Contact the WCU Staff Liaison in advance if you are unable to attend class. Check e-mails regularly and promptly reply or acknowledge receipt. You acknowledge that you are available to participate in classes and activities required for graduation. You understand that each participant must complete a minimum of eight sessions of the ten to graduate from the program and no make-up sessions will be available for missed sessions. Applicants must be registered voters in the City of Weatherford, a resident for at least one year, 18 years of age and not running for local political office during the 10 month program. Twenty-five (25) residents will be chosen to participate. Spouses will not be allowed to participate in the same University class. By checking the box below, this is your online signature, and you agree that you are, in fact, the person named above, and that you are the person making this request on the date provided above. You also certify that all information on this form is represented accurately. The applicant further authorizes the City Council, or its designee, to verify any information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information is considered public pursuant to the Texas Public Information Act.
If not selected for the 2016-17 University, would you like your application to be kept on file for next session?
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