Member Application: Youth Advisory Committee

Name*
First Last
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred Phone Number*
Email*
High School:
Grade in the 2021/2022 school year (Ex: 8th, 9th, 10th, 11th):
Favorite School Subject and Why:
Extra Curricular Activities
In your own words, explain why you would be a good YAC member:
In your opinion, what is the most critical issue facing youth today and why?
Parents Name and contact information