HomeMy WebLinkAboutBergman, Brinlie Application (Youth) 2021 02 21 Applicant Information
Applicants for the Youth Council may be requested to interviewwith the respective appointing City
Commissioner or Mayor and the staff liaison. Please return completed applications to the City
of Winter Springs Winter Springs Youth Council Coordinator, Meghan McNeil, at 1126 East State
Road 434,Winter Springs, FL32708 or email to mmcnelIpwinterspringsfl.org.
Brinlie Avril Bergman 05/15/2005
Full Name bate of Birth
1566 Eagle Wind Terrace
Street Address Apt/Unit Number
Winter Springs Florida 32708
City State Zip Code
813-625-5219 Blingybrinlie@gmail.com
Phone Number Email Address
I 01 Winter Springs High School
202012021 School Year Grade School Name(If home schooled,write"Nome Schooled")
Are you able to attend meetings and activities of Youth Council for one year?
Vyes ❑ No
Do you have reliable transportation to meetings and activities?
Lyes ❑ No
Are you in good academic standing?
VIyes ❑ No
Please list all activities that you participate in during the school year. Include sports,employment,
school groups,community service,and extra-curriculum activities_
I am apart of the Winter Springs Lacrosse Team and I attend practice weekly. I am also
involved with a service club called Interact.For employment,on the weekend I participate with
the family business that services medical and motion furniture_
Short Answer Questions
You may include additional pages to complete answers if necessary.
1. Why do you wish to serve on the Winter Springs Youth Council?What do you hope to gain by
this experience?
I want to serve under Winter Springs council because it will give me a chance to make
positive changes in my community. I hope to improve my leadership, public speaking,
and social skills.
2. What are the most important issues to you,your friends,and your family concerning our
community?
The most important issues that are concerning our community are public safety,
education, and economic factors (including jobs). Another issue that needs to be
focused on is social inclusion.
3. What characteristics or skills do you possess that make you a great representative?
The characteristics that make me a great representative are that I am hardworking,
confident,honest, and a good communicator. I also have a lot of empathy and decision-
making capabilities.
4. Describe past experiences that have prepared you for this leadership role.
A few past experiences that have prepared me for this leadership role was beim a
section leader in my trumpet section and leading them in MPA. I also represented my
class in a reading competition.
Letters of Recommendation
Please submit two(2) letters of recommendations from a teacher,counselor, parent (home
schooled students),or coach.
Parent/Legal Guardian Agreement
I give my permission for the above named applicant to seek a position on the City of Winter
Springs Youth Council and I have read and understand the commitments required for the
Council,
Eric Bergman 678-410-4905
Printed Name Phone Number
eber _gmangsquadservices.com Father
Email Address Relationship to Student
Eric Bergman 2/21/2021
Parent/Legal Guardian Signature Date
Commitment Statement
1 understand that being a member of the City of Winter Springs Youth Council carries certain
responsibilities. I agree to conduct myself in a professional manner as a representative of my
city.
You hereby represent to the City of Winter Springs under penalties of perjury that the
information provided herein is true and accurate to the best of your Knowledge and the City
of Winter Springs has the right to rely on that information.
You hereby acknowledge that you must abide by the Code of Ethics for Public Off'cer1, and
the Florida Sunshine Law, which pertain to you if you are appointed to the Winter Springs
Youth Council.If appointed it is your sole obligation and duty to comply with such laws.
Brinlie Bergman 2/21/2021
Student Signature Date