NORTH SHORE Youth Parliament

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					                                      PERSONAL INFORMATION
Name:_________________________________ Date of Birth: ____________________ Sex (circle): Male Female




                                                                                                                                   19  th
Address:___________________________________________________________________________________


                                                                                                                                        NORTH SHORE
         Street No.                 Street                      City                                 Postal Code
Telephone Number:__________________Cell Number:__________________ E-mail address:________________________
                                       EMERGENCY MEDICAL INFORMATION
B.C. Medical Number (i.e. CareCard Number): ______________________


                                                                                                                                   Youth Parliament
Name of Parent/Guardian:_______________________ Phone #(s):__________________ or _________________
Name of Alternate Contact Person:____________________ Phone #(s):________________ or________________
Please indicate if you are vegetarian or have any food allergies:_________________________________________
Please Note: Unless arrangements are made in advance, participants will be expected to administer their own medication
if any has been prescribed for them. Please notify the Chief Returning Officer of any chronic medical problems (i.e. severe        sponsored by the British Columbia Youth Parliament
asthma, allergies) that might require emergency treatment and explain the emergency treatment that might be necessary.

                                             SPONSORSHIP INFORMATION
Applicants must be nominated by a youth organisation with which they are associated (e.g. school, club, community service
organisation). Please have your principal, teacher or group coordinator complete the first part of this section and three other
members of the organisation fill out the second.
Sponsor: “I, _____________________________ (name of principal/teacher/group coordinator), do hereby nominate this
applicant to stand for election to North Shore Youth Parliament as a representative of _______________________________
(name of school or youth organization).”
Signed:_________________________
Nominators: “We the undersigned, do hereby nominate this applicant to represent us at North Shore Youth Parliament.”
Signed:_______________________ Signed:__________________________ Signed:________________________
                                                   CONSENT AND WAIVER
In consideration for acceptance to North Shore Youth Parliament (NSYP), the undersigned on behalf of the Applicant and
all heirs, executors and administrators, consents to all necessary medical treatment and waives any and all claims for dam-
ages against NSYP, the British Columbia Youth Parliament (BCYP), and the Youth Parliament of British Columbia Alumni
Society, and their directors, officers, and agents for any and all injuries or loss which the Applicant may suffer during, or in
connection with any NSYP or BCYP Session, trip, camp or any other activity.
Parental Consent: “I have read the accompanying material and do hereby allow my son/daughter to attend North Shore
Youth Parliament.” (Mandatory)
Signature of Parent/Guardian: _______________ Signature of Applicant: ___________________ Date: _______________
                                       PUBLICITY AND PROMOTIONAL CONSENT
From time to time, the North Shore or British Columbia Youth Parliament may use individual or group photos of Members
for promotional purposes in newspapers, on bulletin boards at Youth Parliament events, on web pages, in press releases, in
media packages, in newsletters and in slide or video shows.
Parental Consent: “I hereby do/do not (circle one) consent to my son’s/daughter’s name and photo being used for public-
ity and promotional purposes. I understand that if I do not consent to the use of my son/daughter/ward’s likeness in public
relations materials, my son/my daughter/my ward may be excluded from certain activities or events at Session, including the
official group photo.”
Signature of Parent/Guardian: __________________ Signature of Applicant: ___________________ Date: ____________
                                          PERSONAL INFORMATION CONSENT
                                                                                                                                     February 5-7th (2010)
To enable Members to fully participate in the organization’s activities after Session, North Shore Youth Parliament distrib-
utes Members’ contact information throughout the organization in order to keep them informed of NSYP and BCYP events                       West Vancouver Municipal Hall
and activities.
Parental Consent: “In accordance with the Personal Information Protection Act, I hereby do/do not (circle one) consent to
my son’s/ daughter’s contact information being published in the North Shore Youth Parliament Journal.”
Signature of Parent/Guardian: ___________________ Signature of Applicant: ___________________ Date: ____________
What is NSYP?                                              So, what’s Session like?                            Application Process:
North Shore Youth Parliament (NSYP) is a nonprofit,        Parliamentary Session is held at the West Van-      Follow these simple steps and come join us!
non-partisan youth organisation that recognises every      couver Municipal Hall (750 - 17th Street, West       1. Complete all aspects of this application form
young person’s potential to lead and serve in their        Vancouver). Session runs from approximately             (personal info, emergency medical info,
community. Since 1987, NSYP’s aim has been to pro-         4:00pm on February 5th, 2010 to 4:00pm on               sponsorship info, consent and waiver, publicity
vide a forum in which young people can develop skills      February 7th, 2010. Members return home                 and promotional consent, personal information
in leadership, public speaking, and the parliamentary      at the end of each day’s activities. Members            consent).
process, and put these skills into practice through ser-   must attend all of Session and must contact the     2. Attach a $25.00 registration fee. Which includes
vice to youth in their community. For more informa-        Chief Returning Officer before applying if this     lunch on Saturday and Sunday, snacks through-
tion about NSYP and its sponsor organization, the          presents a problem.                                 out the weekend and a copy of the Parliamentary
British Columbia Youth Parliament, please visit our                                                            Journal. Cheques must be made payable to British
website at www.bcyp.org                                    Who can join?                                       Columbia Youth Parliament. Please note that bur-
                                                           Each year approximately 20 youth are “elect-        saries to attend NSYP are available for applicants
So, what do we do?                                         ed” to become Members of NSYP as represen-          who demonstrate need for financial assistance.
NSYP’s year begins with a Parliamentary Session            tatives of their schools or community organisa-     Applicants should indicate their intention to apply
from February 5-7th, 2010. Members get                     tions. To be eligible to stand for “election” you   for a bursary in a short letter attached to their ap-
to:                                                        must be:                                            plication. Fees for applicants not accepted will be
    • Learn about parliament                                   • a resident of or attending school in the      immediately returned. Fees for accepted applicants
    • Interact with other individuals interested in            North Shore                                     who cancel on or after January 28th, 2010 will not
    youth leadership                                           • between the ages of 14 and 18 (inclusive)     be refunded.
    • Improve their debate and public speaking                 as of December 31, 2010                         3. Attach a one-page written statement outlining:
    skills                                                     • nominated by an organisation committed           a. (first-time applicants) why you would like to
    • Debate Cabinet’s legislation, which sets out             to youth                                           become a Member, the other activities you
    NSYP’s activities for 2010                                 • willing to participate fully in activities       are currently or plan to become involved with
    • Speak out on current local, national and                 throughout the year                                in your community and how you believe you
    international issues                                   Individuals from outside the recruitment area          can personally contribute to NSYP.
    • See democracy in action by electing a                who meet the age and nomination requirements           b. (returning applicants) what you learned dur-
    Premier and Leader of the Opposition for               may apply to attend NSYP as Ambassadors.               ing the 19th NSYP, how you personally contrib-
    next year’s Session                                    Such applicants should follow the normal ap-           uted to the 19th NSYP and how you will con-
    • Become a part of the youth parliament                plication process and indicate their intention to      tinue to contribute to NSYP.
    tradition and be remembered in the                     apply as an Ambassador in their written state-      4. Mail your completed application form,
    Parliamentary Journal.                                 ment.                                                  registration fee and written statement to:

NSYP continues throughout the year with the                Additional Information:                                                 Mr Jeff Wilson
                                                                                                                               Chief Returning Officer
activities legislated by the membership at                 For more information please contact:                                    4165 Pelly Road
Session. Members get to:                                                  Ms Jillian Steger                                North Vancouver, BC V7R 4B1
    • Serve the community by planning and                     Chair, North Shore Planning Committee
    participating in service projects                                                                          Applications must be received by January 24th,
                                                                           (604) 889-7826                      2010. Incomplete applications will not be
    • Have fun with the other Members at social                       jillian.steger@bcyp.org
    events                                                                                                     considered until completed . Acceptance of late
    • Stay in touch via “Mr. Speaker” newsletters.                                                             applications is at the discretion of the Chief
                                                                           Mr Jeff Wilson                      Returning Officer. Successful candidates will be
                                                                       Chief Returning Officer                 notified by mail and be sent all materials necessary
    Make a difference while having fun!                                     (778) 318-4910                     for Session, including a detailed schedule.
                                                                        jeff.wilson@bcyp.org

				
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