Government-in-Action Youth Tour
Please fill out and submit this form electronically, or you can download and print the form by clicking here.

Contact Information
Name: Parent's Name:
Address: Guardian’s Name:
BTU Account #: Address:
Home Phone: Home Phone:
Work Phone: Work Phone:
E-Mail Address: E-Mail Address:
Age: Grade & Graduation Date
Academics/Activities
During which hours are you available for volunteer assignments?
School Attended:
Organizations:
Extra-curricular Activities:
Special Activities
In the space below please tell us what activities you are involved in.
Why would you make a great community Representative to Washington D.C.
In the space below, please tell us why you would like to go to Washington D.C.
Essay Topic:
What are the differences between an electric cooperative, investor owned utility, and a municipally owned utility? Be descriptive as possible. Limit to 2 pages please!
Person to Notify in Case of Emergency
Name: Relationship:
Street Address:
City State Zip Code
Home Phone: Work Phone:
Email Address:
Parent/ Legal Guardian and Student Affirmation
We affirm that (1) all information provided on this application is correct, (2) the parent has given permission for the student to enter this contest and to participate in the Youth Tour should he/she win, (3) the Student agrees to participate in the Youth Tour on the scheduled dates should he/she win, and (4) the Student agrees to all conditions and rules set forth by BTU and to fully execute all obligations and responsibilities