TAY Advisory Board Application
Thank you for your interest in joining the CAYEN Board! CAYEN elevates the voice of Transitional Age Youth (TAY; ages 15-26) with lived experience in the behavioral health, juvenile justice, and foster care systems to help lead transformative local and state wide change to our mental health system. We look forward to the possibility of bringing your leadership on to our Board.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Age
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Date
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Month
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Day
Year
Date
Pronouns
Do you or someone you are close to, have personal or professional experience in any of the following systems? Please check all that apply:
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Runaway Homeless
Substance Abuse
Child Welfare
Juvenile/Criminal Justice
Didn't Complete High School
Foster Care
Mental/Behavioral Health
Residential
Homelessness
Other
If other, please specify below.
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Looking at this list of community issues listed below, please check all that apply within your community or have personal experience with?
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Education
Mental Health Wellness and Self Care
Housing
Arts & Music Programs for Youth
Lack of Cultural Competency
Criminal Justice
Lack of Access to Healthy Foods
Gang and Violence Prevention
Job Development
LGBTQIA+
Teen Pregnancy
Homeless Youth
Youth Substance Use (Drugs/Alcohol)
Social Justice
Youth and Family Violence
Mental Health Coverage and Access
Other
If other, please specify below.
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Are you currently a student?
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Middle School
High School
College or Trade School
No, I'm not currently a student.
What skills would you bring to the CAYEN TAY Board? What was your experience in developing these skills? And why are they important for TAY empowerment? Examples: Leadership, group facilitation, organizational planning, public speaking, technology, creativity, etc.
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What are your interests as it relates to Transitional Age Youth Mental Health? What has influenced these interest? And what do you hope to change at the local or state level as it relates to TAY Mental health if nominated onto the board?
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Please describe any past experience working on a board, team or committee, and or within community. What did you like from that experience? What did you learn?
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REFERENCES
Reference #1
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email
*
example@example.com
Reference #1
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First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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