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Student Transit Riders Commission Application

Personal Information

First Name:

Last Name:

Type of School:

Grade in 24/25 school year:

Date of Birth:

Age:

Street Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

How did you learn about the Student Transit Riders Commission?

Please specify:

Are you available to attend meetings once a month and other activities planned by the commission throughout your one-year term?

Yes No

If chosen, can you commit to at least a full year's term as a commission member?

Yes No

Parent/Guardian Information

Parent/Guardian First Name:

Parent/Guardian Last Name:

Relationship to Applicant:

Phone Number:

Email Address:

Emergency Contacts

Autofill from parent information

Primary Contact

First Name:

Last Name:

Relationship to Applicant:

Phone Number:

Secondary Contact (optional)

First Name:

Last Name:

Relationship to Applicant:

Phone Number:

What made you interested in joining the Student Transit Riders Commission?:

What extracurricular activities are you involved in?:

What skills and qualities do you posses that you feel would serve the commission well?:

What are some of the main challenges faced by young people today as it related to getting around?:

What are some of your expectations and goals for the committee?:

Acknowledgment

I have read and understand the commitment required of the Student Transit Riders Commission. If selected as a commission member, I acknowledge that I will be expected to participate in monthly meetings, activities, projects, and special events throughout the year. I acknowledge that all statements and information provided in this application are true to the best of my knowledge.

Hampton Roads Transit will reach out to the contact email provided with next steps regarding your application within two weeks of submission.

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Student Transit Riders Commission Application

Personal Information

Parent/Guardian Information

Emergency Contacts

Primary Contact

Secondary Contact (optional)

Acknowledgment