Branch County Community Foundation Youth Advisory Council
Membership Application
Date of Application:
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Month
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Day
Year
Date
Name
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First Name
Last Name
Date of Birth:
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Month
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Day
Year
Date
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone #:
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Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone #:
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address:
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(Please provide an e-mail address that is most checked by you, as it may be used to contact you about your membership, meeting notices, and other important information)
School you attend:
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Expected Graduation Date:
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Why are you interested in joining YAC?
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In your own words, explain why you would be a good YAC member.
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How do you think you can benefit from YAC membership?
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Please list and describe your interests, and which interest means the most to you.
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What does "community Service" mean to you?
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Describe something unique about yourself that you could offer YAC and our community.
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In your opinion, what is the most critical issue facing youth today and why?
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YAC meets each month from September through May. One of the responsibilities of a YAC member is attending the meetings. Will you be able to attend our monthly meeting on the third Sunday of each month?
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Definitely Yes
Probably Yes
Not Sure
I can't make it
How many hours a month would you be able to commit to YAC outside of regular YAC meetings?
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What other activities (sports, clubs, etc.) are you involved with in and out of school for the coming year?
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Activity (sports, clubs, etc.)
Date(s) of Commitment
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2
3
4
Will these activities impact your meeting attendance?
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Yes
No
How did you learn about YAC?
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List two adult references (other than your parents or family members). Please include their names, addresses, home phone numbers, and e-mail addresses.
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Rows
Name
Address
Phone #
Email Address
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2
For the Applicant: I understand that if I am selected as a member of the Branch County Community Foundation’s Youth Advisory Council, I will be committed to attend monthly meetings on the third Sunday of every month (date and time subject to change), and at least 75% of meetings, special events, and other YAC activities throughout the year. I will be an active participant and a positive representative of the Council.
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Signature of Applicant
For the Parent/Guardian: I give permission for my child to apply to be on the Branch County Community Foundation’s Youth Advisory Council (YAC). If selected, I will permit and support him/her in attending meetings and activities related to the YAC.
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Signature of Parent/Guardian
Submit
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