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2. Have your voice heard and make a difference! Youth Council members provide feedback, ideas and suggestions on city-wide initiatives, programs and issues facing youth in Coquitlam and give back through volunteering. Open to Coquitlam residents in Grade 10 and 12. Youth Council meets every second Wednesday from 4 to 5 p.m. from mid-September to June.

   Applications will be accepted from July 6 to August 17, 2026. 

4. First Name*
5. Last Name*
7. Preferred Pronouns*
8. Date of Birth*
   Date of Birth
10. Street Address*

    Must be a Coquitlam resident

12. City*
13. Province*
14. Postal Code*
16. Phone Number*
17. Email Address*
19. Name of Emergency Contact Person*
20. Phone Numbers of Emergency Contact Person*
22. Grade*

    Must be going into grade 10, 11 or 12.

23. Name of School*
25. Do you have any accessibility or inclusion needs?*
27. Please detail your previous volunteer experience and provide a list of your responsibilities.*
29. What are some of your hobbies and interests?*
31. Why do you want to join the Coquitlam Youth Council?*
33. What skills do you bring to the Coquitlam Youth Council?*
35. What is your favourite thing about living in Coquitlam?*
37. How did you hear about the Coquitlam Youth Council?*
39. Is there anything else you want us to know?*
41. Privacy Statement*

    By submitting this form, you are consenting to the collection, storage, use and disclosure of your personal information for the purposes of the City’s Youth Council Application process in accordance with Section 26(c) of the Freedom of Information and Protection of Privacy Act. Your personal information will be disclosed to a third-party service provider (i.e. website host Civic Plus) located in Canada for the purpose of processing your request. Should you have any questions or concerns about the collection of your personal information, please contact Jennifer Couture - City of Coquitlam Youth Coordinator, by email. 

    1. I consent
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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit