Diocesan Youth Council Application

Personal Information

Applicant's First Name REQUIRED Please fill out this field. Please enter valid data.

Applicant's Last Name REQUIRED Please fill out this field. Please enter valid data.

Parish Name REQUIRED Please fill out this field. Please enter valid data.

Parish City REQUIRED Please fill out this field. Please enter valid data.

Cell Phone REQUIRED

Please fill out this field. Please enter a phone number.

Home Phone REQUIRED

Please fill out this field. Please enter a phone number.

Teen Email REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field. Please enter valid data.

Zip Code REQUIRED Please fill out this field. Please enter an integer (number).

Birthdate REQUIRED Please fill out this field. Please enter a date.

Age REQUIRED Please fill out this field. Please enter an integer (number).

Sex Male Female

Shirt Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large

High School REQUIRED Please fill out this field. Please enter valid data.

Grade in School REQUIRED Please fill out this field.

Name of Parent(s) or Guardian(s) REQUIRED Please fill out this field. Please enter valid data.

Primary Phone Number for Parent or Guardian REQUIRED Please fill out this field. Please enter valid data.

Alternate Number for Parent or Guardian Please enter valid data.

Parent Email REQUIRED Please fill out this field. Please enter valid data.

Parent(s) or Guardian(s) agree to youth's participation on the Diocesan Youth Council. Yes No

Have you attended a youth leadership conference? yes No

If yes, which youth leadership conference did you attend? REQUIRED Please fill out this field.

If Other, please list. Please enter valid data.

Application Questionnaire

1. Why do you want to be a member of the Diocesan Youth Council? REQUIRED Please fill out this field.

2. What skills do you possess that will enable you to be an effective Youth Council member? REQUIRED Please fill out this field.

3. Illustrate how you have previously demonstrated these skills. REQUIRED Please fill out this field.

4. What does "making a commitment to be on the Diocesan Youth Council" mean to you?

5. Describe your involvement in the Catholic Church. (List all activities that you do: Altar server, Cantor, Youth Commission, Participate in Youth Ministry Activities, etc.) REQUIRED Please fill out this field.

6. What other activities are you involved with outside of Church? REQUIRED Please fill out this field.

What goals would you like to achieve as a Youth Council Member? REQUIRED Please fill out this field.

Please have your pastor, youth minister, campus minister, catechist, or teacher submit a reference for you at the following link:

DYC Reference

Pastoral Office for Catechesis

Diocese of Lafayette-in-Indiana

Diocesan Youth Council Application

Documents