Teen Advisory Group Application

    Your Name (required)

    Your Email (required)

    Your age

    Your grade (required)

    How many months are you willing to commit? (The board meets once/month.)
    3 months4 months5 months6 monthsMore than 6 months

    Days you would be available (check all that apply)
    Monday 3pm-6pmTuesday 3pm-6pmWednesday 3pm-6pmThursday 3pm-6pmThursday 6pm-9pmFriday 3pm-5pm

    Why do you want to join the Teen Advisory Board?

    Anything else you'd like us to know?

    Person to contact in case of emergency (required)

    Relationship

    Emergency telephone number (required)