MAYAC Application

Midland Area Youth Action Council

Membership Application
In selecting new members, the Midland Area Youth Action Council is looking for people who:

-- care about their community and want to make a difference

-- bring diverse perspectives to our council

-- are open-minded, critical thinkers who can discuss tough issues and creative solutions

-- demonstrate integrity and initiative in their actions and decisions

Expectations of Youth Action Council members:

-- Attend & engage in monthly Youth Action Council meetings, Committee Meetings, and other volunteer opportunties.

-- Actively participate in decision-making and activities

-- Be an advocate for the council, the Midland Area Community Foundation and youth in our community
Which of the following qualifies you to be a part of the Youth Action Council?*

I am a resident of Midland County.I attend school in Midland County.
Name*

First NameLast Name
E-mail*
Alternate E-mail
example@example.com
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 e-mail*
example@example.com
Parent/Guardian 1 Phone Number

Area CodePhone Number
Parent/Guardian 1 Address (if different than the address you listed for yourself)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 e-mail
example@example.com
Parent/Guardian 2 phone

Area CodePhone Number
Parent/Guardian 2 Address (if different than the address you listed for yourself)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In what year will you graduate?*
What school do you attend?*
How old are you right now?*
What is your birth date?*
ex: 9/14/2001
How do you identify your ethnicity? (select all that apply)*

American Indian or Alaskan NativeAsianBlack / African AmericanNative Hawaiian or Other Pacific IslanderCaucasian / WhiteLatinx / Latino / LatinaTwo or More RacesNative AmericanMiddle EasternPrefer not to answerOther
By what pronouns should we address you?*
Why do you want to serve on the Youth Action Council?*
Have you volunteered before?*

YesNo
If you've volunteered before, please tell us about what you did:
What are the TOP 3 Issues facing young people in our community?*
How do you think you {and the Youth Action Council} can help our community?
What skills or characteristics make you a good representative for Midland's young people?*
What other activities will you be involved in this school year?*
Reflect on a challenge that you faced in your life -- What did you learn? How has it impacted you?*
Tell us about you! People are diverse and that's the AWESOMENESS of this Council - Different Perspectives! Be as creative {or not} as you'd like here. We added an option to upload different stuff, if you've got something you'd like to share, include that too!

A few ideas:

{family, friends, aunts, uncles -- who are your people?}

{what are your favorite non-studying things to do?}

{things you would change if you could?}

{ANYTHING you'd like to share}
Tell us ---
Upload something to share---

Upload a File

Cancelof
Show us something --
Should be Empty:

Midland Area Youth Action Council