NJ RISE Youth Advisory Board Interest Form

Lindsey Meyer Teen Institute NJ RISE Youth Advisory Board Interest Form

Hello! Thank you for your interest in joining the LMTI NJ RISE Youth Advisory Board. The purpose of the NJ RISE Youth Advisory Board is to provide youth advocacy and community change to students. We will touch upon addiction & mental health prevention programs that you would like to see in your communities and schools. In addition to this we aim to provide participants with life skills (public speaking, resume building, community service hours, etc.) and other workshops that will help them grow as leaders and as awesome human beings! Please answer the questions below to the best of your ability. If you run into any questions please email jramos@pipnj.org or mramos@pipnj.org
Full Name

First NameLast Name
Preferred Name
Preferred Pronouns (check all that apply)
Student's school email address
example@example.com
Student's personal email address
example@example.com
Parent Name/Legal Guardian Name

First NameLast Name
Parent /Legal Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Legal Guardian E-mail address
example@example.com
What grade are you currently in?
What school are you currently attending?
Town of Residence
What do you hope to gain from joining the NJ RISE YAB?
What types of skills/activities are you interested in doing during virtual meeting times? (Select all that apply), (if others please specify).

Other
Please select all the dates you are able to attend virtually for the zoom meetings?
If you are comfortable sharing, is there anything fun or exciting you would like us to know about you?
If you are comfortable sharing, what is one childhood memory that comes to mind that brings you joy?
When meeting new people, would you consider yourself:
What are some extracurricular activities you are involved in school, if any please share with us we would love to know more about you :).
What do you enjoy to do in your free time or on the weekends?
What is your go-to snack that you would not change for the world? (Choose one), if other please share with us why it is awesome?

Other
Should be Empty: