Teen Council Application ApplicationName *Email Address *Phone *Birthdate: *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000School *Select *Grade789101112Parent/Guardian Name: *Parent/Guardian Email: *Parent/Guardian Phone *Parent/Guardian: Do we have your permission to photograph your child and post them on social media? *YesNoAbout YouWhat days of the week are you NOT available?MondayTuesdayWednesdayThursdayFridaySaturdayWhat times of the day are you NOT available (meetings would not be before 3:30pm):Do you have any food or drink allergies? *Do you have any hobbies or special talents?What kind of books do you like to read?What music do you listen to?What is your favorite movie?What is your favorite food/snack?What is your favorite drink?Is there anything you would like us to know?Do you have any questions?Student signature: *Type Name as SignatureParent/Guardian Signature: *Type Name as SignatureDate *Mission Statement & Code of ConductMission StatementThe mission of the Beauregard Parish Library's Teen Library Council is to encourage students age 12-19 to become life-long library users through the promotion of reading, volunteering, and participation in the library, and to assist the library in both developingand implementing programs which serve local teens.Code of ConductAs a TLC member, I will adhere to the library's Patron Behavior Policy and will: Attend all TLC meetings unless otherwise excused in advance by the TLC Advisor. Be trustworthy and reliable in carrying out responsibilities I've accepted. Take responsibility for my choices and accept the consequences of my actions. Work cooperatively with the library staff and other TLC members. Respect others' opinions and make every attempt to include all participants in activities. Respect all persons, facilities, and vehicles. I will be responsible for any damage caused by my behavior. Look out for the safety and well-being of others and will act quickly to report anything which threatens it. Accept that I am a role model and will use proper etiquette, including: No public display of affection Dress respectfully- shirts and bottoms should cover body parts which undergarments are typically used to cover. Use electronics appropriately during the meeting No profanity or weapons (such as pocket knives) I understand and agree to the terms and conditions of the Code of Conduct. I understand the following procedures will be taken if I do not uphold the Code of Conduct: First Offense: You will receive a warningSecond Offense: Your parent/guardian will be contactedThird Offense: You will be removed from the council Please note: Extreme or severe violation of the Code of Conduct, as determined by library administration, may result in immediate removal from the council.Student signature: *Type Name as SignatureParent/Guardian Signature: *Type Name as SignatureDate * Send MessagePlease do not fill in this field.
