Application for Youth Advisory Council

Please submit your information by filling out the form below.
Required Fields are indicated in red

  Last Name

City State Zip Code
Are you a resident of the City of Rockwall?
Home Phone
(000) 000 - 0000
Cell Phone
(000) 000-0000
Grade Age Date of Birth
Clubs & Activities Involvement  
(please do NOT use single or double quotation marks in your entry)

Please submit two letters of recommendation from a teacher, counselor,
principal or adult family friend with your application. 

You may scan and e-mail these letters to

fax them to (972) 771-7727

mail them to:

Rockwall City Hall,
Attention City Secretary,
385 South Goliad Street 
Rockwall, TX 75087.

Participation requirements are part of the YAC program.
Are you willing to commit to the time & effort required?

(Check for Yes, leave blank for No )

Please answer the following question:
You MUST enter the correct answer (12).
Otherwise you'll be directed to a SPAM Trap

What is 3 x 4?