Washington Youth Tour

Washington Youth Tour Application

First

Last

Jackson Energy Account Number

Address

City/Town

State/Province

ZIP/Postal Code

Physical Address (if different from Mailing Address)

City/Town

State/Province

ZIP/Postal Code

Student Cell Phone

Student Email Address

School

Expected Graduation Date

Parents/Guardian

Parents/Guardian Phone

Parents/Guardian Email Address

Have you visited Washington. D.C. before?

Yes

Why do you want to go on the Washington Youth Tour?

School and/or Extracurricular Activies:

In your own words, describe the purpose of an eletric cooperative:

Please upload a copy of your Transcript

Please upload a Teacher Recommendation Letter

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