2026 Action & Family Council Interest Form
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  • 2026 Action & Family Council Interest Form

    May-August 2026

  • Thank you for your interest!

    Please complete this Form if you are interested in joining your Region’s Birth to Five Illinois Action or Family Council. We welcome people with a range of experience, including those who are new to community councils and boards.

    If you live, work, or receive Early Childhood services in more than one Illinois Region (www.birthtofiveil.com/map/#region), fill out the information below based on the Region you want to represent or where you feel your contribution will have the greatest impact.

    Questions? Please contact us: www.birthtofiveil.com/contact

  • Basic Information

  • None of your information will be shared with anyone outside of Birth to Five Illinois.

  • Format: (000) 000-0000.
  • We will email you unless you prefer another form of communication. Please tell us how you would like us to follow up with you.*

  • Optional: Tell Us About Yourself.

  • You do not have to answer these questions, but they will help us create Action & Family Councils that are diverse. Your answers will not be shared with anyone outside of Birth to Five Illinois.

  • Action & Family Council Interest Form

  • Each Region has an Action and a Family Council.

    • Our Action Council is a space for Early Childhood professionals and community partners to meet and talk. 
    • Our Family Council is a space for parents and caregivers of children age 8 or younger to meet and talk. 
    • If you have a child age 8 or younger, you can choose if you want to submit an Interest Form for the Action or Family Council.

    You can also go to www.birthtofiveil.com/councils for more information. Answer the question below to continue to the Interest Form questions.

  • Do you currently have a child in your care who is under the age of 8?
  • Do you want to submit an Interest Form for the Action or Family Council?

  • Action Council: Interests & Experiences

  • These questions help us ensure the Action Councils represent the diversity of each Region.

  • Choose up to three job titles or roles that best describe your professional experience.*

  • We want to know more about your interest in Early Childhood. We welcome people with a range of experiences, including those new to advocacy, collective impact, and efforts that support young children and their families.

  • Birth to Five Illinois values racial equity and inclusion. Our Racial Equity Value/Goal is as follows: In an effort to move our Early Childhood system to one where racism no longer impacts a child's success, we will work to dismantle barriers that have limited access to high-quality services for minoritized children in every corner of our State.

  • We are striving to create a more equitable system for children and families and want to include people from a wide variety of lived and professional experiences. Part of the way we do this is to invite people from, or who work with, individuals in “priority populations”, which are twelve demographic groups identified by the Illinois Early Learning Council (2021).To find more information about priority populations or to see the full list, please click visit: https://idec.illinois.gov/content/dam/soi/en/web/idec/documents/unsorted-documents/priority-populations-updated-2021.pdf

  • Do you have lived or professional experience with any of the State’s priority populations? If so, please check all that apply.*

  • Family Council: Interests & Experiences

  • These questions help us ensure the Family Councils represent the diversity of each Region.

  • Early Childhood programs and services are defined as those that support the growth, development, and learning of a child under age 8. Do you take your child out of your home for programs or services? Or does someone come into your home to provide support to your child?

  • If either of these are true for you, select yes. If neither one is true, select no.*
  • Tell us about your family. (Please check all that apply.)
  • We want to create Family Councils that include people from many backgrounds. Please select any of the options below that apply to you or your family members. (Please only select what you are comfortable sharing. Your answers will not be shared with anyone outside of Birth to Five Illinois.)
  • Tell us how long you have lived in your community.*
  • If you are not selected for the Family Council, would you like to be considered to represent the family perspective on the Action Council? To learn more about the Action Council, visit www.birthtofiveil.com/councils.*

  • Wrap-Up

  • How did you hear about the Birth to Five Illinois Councils?*

  • You will receive an email once you press Submit below. If you do not receive an email confirming your submission, we did not receive your Interest Form. You will need to fill the Interest Form in again and re-submit.

    If you need help with submitting your Interest Form, contact info@birthtofiveil.com. 

    All Interest Forms will be reviewed by Birth to Five Illinois in August. You will be contacted shortly thereafter. Thank you for your interest in joining our efforts to support young children!

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