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County of Brant Youth Advisory Group Application

The County of Brant is pleased to announce the creation of a new Youth Advisory Group. If you are interested in becoming a member, please complete the application form below.

First Name:

Last Name:

Email:

Telephone Number:

Age:

By checking this box, I:

confirm the information provided is correct.

understand if I am selected, parental/guardian permission may be required

Today's Date:

Applicant Signature:

Clear