Join The Council 👋😄

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What is the date? 🗓️* This field is required.
Date
Year
Month
Day
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Oh hi there 👋
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What's your name? 🤔* This field is required.This can be your legal name or your preferred name, and please include your pronouns in the "First Name" box if that's important to your identity
First Name
Last Name
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What is your email? 📨Its okay if you don't have one, we'll ask about phone number next if that's more relevant for you
example@example.com
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What is your phone number? 📲Its okay if you don't have one (if you don't have a phone number or email, please share at the end on the "Anything Else❔" question how we can get ahold of you)
Please enter a valid phone number.
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How old are you? 🐣* This field is required.
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Do you currently, or have you before, lived in Linn, Benton, or Lincoln county in Oregon?* This field is required.Ex: Newport, Lincoln City, Corvallis, Albany, Lebanon, and more!
Linn County
Benton County
Lincoln County
I don't know
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How Our Council Works
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Image Field
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Our apologies, we're currently full for new members in Linn County 😶

Since we serve Linn, Benton, & Lincoln counties, and we only have so much funding, we have to cap the # of council members we have to ensure we have space for youth from other counties. If you would still be interested in participating next year (2026), please continue finishing this form and we will reach out to you as soon as we have space 💖. If you haven't already, you are welcome to "Be Paid to Share Your Story 🗣️💸", which is another paid opportunity we have available. Once you complete this form, you'll be redirected to our council's website where there will be an easy-to-find button to sign-up for it 🙂
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What system(s) did you receive care from in Linn, Benton, or Lincoln county & want to "share your story" about? 🏫🚓🏥🏡💭* This field is required.If you do not understand this question, that is okay, click the "I don't know" and we'll help explain when we follow-up with you. If your system is not listed, please share what system it was on the "Anything Else❔" question at the end of this form
Juvenile Justice System 🚓
Medical System 🏥
Education System 🏫
Child Welfare System 🏡
Mental Health System 💭
Other (not listed)
I don't know
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Why are you interested in joining our council? 🤔No right or wrong answer, feel free to speak as honest & open as you're comfortable sharing
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What change(s) would you like to see in the system(s) that serve young people? What would you like to see more of (what is working👍), and what would you like to see less of (what isn't working or is harming👎)? 😶‍🌫️
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Do you have any questions you would like answered? 🫡We will make sure to answer any and all questions when we reach out to follow-up on this application
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How are you feeling about all this?
What's the vibe?
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What's the vibe?
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Anything Else ❔Is there anything else you would like us to keep in mind? Remember if you didn't share before, please let us know (1) how we can get ahold of you, and (2) what system you received care from if it wasn't listed. Also please let us know if you require any accommodations, we are happy to meet you where you are at 😊
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I understand that the #TheTeaInLBL Youth Advisory Council has limited space and a finite amount of funding 💰, and though it will do its best to invite every young person that submits this form to join our council, it may not be able to immediately 💖* This field is required.If for whatever reason we can't right away, we will ask you if we can hold onto your request to then contact you when we are able to meet with you!
Makes sense 👍
Doesn't Make Sense 👎 (we'll share more info when we follow-up with you)
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