Congressional Youth Advisory Council Application

The Congressional Youth Advisory Council of U. S. Representative August Pfluger offers high school juniors and seniors an excellent opportunity to learn about government, collaborate on and discuss various topics with Congressman August Pfluger and fellow high school students, and provide service to the 11th Congressional District of Texas.

The CYAC program consists of up to four interactive virtual meetings with the Congressman, special guests, and senior staff members. If accepted into the program, you must be able to attend at least three meetings, which will be scheduled after school hours. Additionally, CYAC participants will be provided special admittance to the Pfluger Youth Leadership Conference in Spring 2024 (Date TBD).

*Note: All meeting dates are subject to possible changes in the Congressional calendar.

Our Mission:

The 11th District Congressional Youth Advisory Council empowers students to speak out and make a difference in their communities and government. The Council broadens Congressman Pfluger’s perspective on issues affecting young people, while students have the unique opportunity to learn about the development of public policy.

FUNDING:

The Congressional Youth Advisory Council is at NO COST to the participants. All materials will be provided to the participants.

ACADEMIC CREDIT:

Academic or community service credit may be available to you from your high school. Our office will provide proof of service at your request.

THE APPLICATION:

To apply, please fully complete all sections of the attached application. Failure to provide complete answers may affect the review or consideration of your application.

The deadline to submit application is: December 15, 2023

If you have any questions about the application or general inquiries regarding CYAC, please call Corbette Padilla in the Midland district office at 432.687.2390.

Required fields are followed by *.

Your Information

First Name: *

Last Name: *

Grade Level: *

Home Address: *

City: *

Zip: *

Home Phone: *

Cell Phone: *

Email: *

Age: *

Date of Birth: *

If over 18, are you a registered voter?: * Yes No

School: *

Cumulative GPA: *

GPA Scale: *

List all clubs and activities, including any leadership positions: *

If selected, what topics would you like to discuss at CYAC meetings?: *

Do you have any relatives who are in public service on public boards/commissions? (If yes, please list.):

Please have read following statement and acknowledge it via checkbox and providing today's date:

I certify that the information on this application and any additional material submitted is true and complete to the best of my knowledge.: *

Date: *

Please have your Parent/Guardian read the following statement and acknowledge it via checkbox and providing today's date:

I do hereby give consent for my child to participate in the Congressional Youth Advisory Council and understand the time commitment involved for this program.: *

Date: *

Additional Requirements

Please attach the following required documents to your application:

A personal statement.
Briefly tell us about yourself, discussing your interests, goals for the future, what you hope to achieve if chosen for CYAC, etc. Please limit to one page. *

Documents must be the following file types: .doc, .docx, .pdf, .txt

Macintosh users: Your document must have a file extension. Resave it using your word processor with the appropriate extension from the above list.

Personal or Parental Release

To: Congressman August Pfluger’s Office

Event or Activity: Congressional Youth Advisory Council & related activities

Participant: *

I understand that my participation in the above event or activity is offered on a voluntary basis. I agree to assume all risks for injuries resulting from my participation in volunteer activities. Additionally the Office of Congressman August Pfluger has my permission to use and publish my photograph in the media or other official communications platforms, such as the Allred Office website, newsletter, press releases, social media, etc., including the World Wide Web, to promote the Congressional Youth Advisory Council. I understand that I will receive no compensation for any photos taken or used. If participant is under the age of 18, consent must be provided below by a Parent/Guardian.

Is the Participant an Adult or under the age of 18?: * Adult Under the age of 18

Name of Parent/Guardian: *

Please check here once you have read and acknowledged the liability release information above: *

Date: *