2026 Wilsonville Civics Academy Application

Name: *

Place of Employment:

Email Address: *

Home Phone Number: *

Cell Phone/Other:

Home Address: *

Why would you like to be a participant in the Wilsonville Civics Academy? *

What experience, community activities, or volunteer experience will you contribute to the program? *

What do you hope to gain from completing the Wilsonville Civics Academy? *

Have you reviewed all meeting dates and times, and do you agree to attend each session, be on time, and to be an engaged participant? *

Yes

How did you hear about the program? *

Electronic Signature Agreement
By selecting the "I Accept" button, you are signing this agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement.

I Accept: *

Yes

Date signed *

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