Commonwealth of Virginia - Wild Apricot



4000500-114300NOTICE: YOU MUST FILE THIS FORM WITH THE VIRGINIA YMCA BY THE FILING DEADLINE. FAILURE TO DO SO MAY RESULT IN YOUR DISQUALIFICATION. 00NOTICE: YOU MUST FILE THIS FORM WITH THE VIRGINIA YMCA BY THE FILING DEADLINE. FAILURE TO DO SO MAY RESULT IN YOUR DISQUALIFICATION. VIRGINIA YMCA MODEL GENERAL ASSEMBLYCERTIFICATE OF CANDIDATE QUALIFICATIONI hereby certify that:I am a student at a Virginia public or private school.I am presently a junior on the date of the general or special election for the office I am seeking.I am a dues-paying member of a Hi-Y, Tri-Hi-Y, or Youth & Government Club affiliated with the Virginia YMCA.I now reside at the address provided below.Have you ever been convicted of a felony?Have you ever been adjudicated mentally incompetent? FORMCHECKBOX YES FORMCHECKBOX NO FORMCHECKBOX YES FORMCHECKBOX NO FORMCHECKBOX YES FORMCHECKBOX NO FORMCHECKBOX YES FORMCHECKBOX NO FORMCHECKBOX YES FORMCHECKBOX NO FORMCHECKBOX YES FORMCHECKBOX NOPlease TYPE or PRINT LEGIBLY all the following information:FULL NAME: FORMTEXT ?????PARENT NAME(S): FORMTEXT ?????MAILING ADDRESS: FORMTEXT ?????HOME PHONE: FORMTEXT ?????MOBILE PHONE: FORMTEXT ?????E-MAIL ADDRESS: FORMTEXT ?????SCHOOL/YMCA: FORMTEXT ?????OFFICE SOUGHT: FORMCHECKBOX Governor FORMCHECKBOX Lieutenant Governor FORMCHECKBOX Attorney General FORMCHECKBOX House Speaker I do solemnly swear [or affirm] that the information given above is true and correct and that I am qualified to vote for and hold the office for which I am a candidate. I agree to the Code of Conduct on the opposite side of this form.Signature of Candidate_______________________________________ Date _____________I am aware that this student is filing for candidacy for the above office and is one of our club’s two nominees. I fully support them and their ability to represent the Virginia YMCA in this capacity and have no knowledge of any recent school infractions. I will notify the Virginia YMCA of any changes. Signature of Advisor_________________________________________Date_____________01905RETURN SIGNED COPY TO THE VIRGNIA YMCA.This form may be filed as soon as you decide to seek an office but must be received by 4:30 PM on February 28, 2023. Candidates will be contacted about speech requirements and must adhere to strict deadlines. Campaign paraphernalia including buttons, shirts, signs, etc. is strictly forbidden at all times. To be eligible for election, candidates must be present the entire weekend at MGA.00RETURN SIGNED COPY TO THE VIRGNIA YMCA.This form may be filed as soon as you decide to seek an office but must be received by 4:30 PM on February 28, 2023. Candidates will be contacted about speech requirements and must adhere to strict deadlines. Campaign paraphernalia including buttons, shirts, signs, etc. is strictly forbidden at all times. To be eligible for election, candidates must be present the entire weekend at MGA.2023 officer candidates will serve at the 2024 MGA. Limit of two candidates per school/group.The Officer Candidate and Advisor must check off each of the following items, sign the front, and return this form. FORMCHECKBOX I understand that Model General Assembly is part of an ongoing “at home” youth civic engagement program, rather than the only experience. FORMCHECKBOX I understand that I will not campaign in any way prior and during the Model General Assembly aside from meeting people. This includes but not limited to social media, printed material (including shirts, buttons, and stickers), and impromptu speeches during the Model General Assembly. FORMCHECKBOX I understand that I must maintain at least a 2.5 GPA during the years of my candidacy and service. FORMCHECKBOX I understand that I will always represent myself and the Virginia YMCA in the highest standard in social media. I will also not create any social media groups using the Virginia YMCA name or the names of any of its programs (including MGA). FORMCHECKBOX I understand that I will always contact Sharon Davies, Executive Director, before speaking on behalf of the Virginia YMCA. FORMCHECKBOX I understand that it is my obligation to attend as many Virginia YMCA events as possible, including but not limited to the Virginia YMCA Officer Retreat, Leadership-in-Action Workshop, and conference-wide trainings. That these are required events unless you obtain approval from the Virginia YMCA. FORMCHECKBOX I understand that any negative behavior during school resulting in suspension will result in me forfeiting my officer position. In-school suspension is at the discretion of the Virginia YMCA. FORMCHECKBOX I understand that I will serve as a role model to the entire of the Model General Assembly and will exhibit good character at all times. The Virginia YMCA Elections Committee and/or Staff will determine what constitutes good character. FORMCHECKBOX I understand that I will be held to a higher standard because of my position. This includes behaving well at YMCA social events, speaking kindly about others, not violating curfew and following the MGA Guidelines. FORMCHECKBOX I understand that I must follow the YMCA four core values of Respect, Responsibility, Honesty, and Caring. FORMCHECKBOX I understand that I must respond and follow all communication between myself and the Virginia YMCA. FORMCHECKBOX I understand that I must keep my social media clean of explicit material and/or anything that violates the YMCAs core values. The Virginia YMCA will determine what explicit material is and what violates the core values. FORMCHECKBOX I understand that I must follow all deadlines set by the Virginia YMCA. FORMCHECKBOX I understand that I will adhere to all rules the Virginia YMCA has in place for officers. FORMCHECKBOX I understand that all the standards listed above, and that violation thereof will result in my nomination being withdrawn, my candidacy being revoked, or being removed from office. FORMCHECKBOX I understand that the Virginia YMCA, in consultation with the MGA Elections Committee Chair, has the full discretion to replace a removed Officer. ................
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