Youth Advisory Board Member Application

Applicant Information

Name(Required)
Preferred Name
Address(Required)

Parent/Guardian Information

Parent/Guardian Name(Required)

Youth Board Member Commitments

Please review the expectations below. By checking each box, you confirm your understanding and agreement.(Required)

Short Answer Questions

References

Please list two non-family adults (teachers, coaches, mentors, etc.) who can speak to your character and reliability.
Reference #1: Name(Required)
Reference #2: Name(Required)

Consent & Release

Student Consent(Required)
Parent Consent(Required)
Clear Signature
Clear Signature