VT Youth Advocacy Council Application

BE A LEADER AND A CHANGE MAKER!!!

We are looking for candidates, ages 14 to 24 years old (both in and out of school), who have some type of disability. This group is comprised of youth and young adults with disabilities who expressed interest in participating in both leadership training and opportunities to impact how Vermont prepares students with disabilities for life after high school. Members connect with other students in Vermont, advocate for youth resources, and lead while providing community service.

The council will have a supportive steering committee initiated by HireAbility VT (formerly VT Vocational Rehabilitation). An annual Youth Summit is planned and run by the Youth Advocacy Council members, driven by youth for youth. Youth Advocacy Council members are compensated for their time.

Answering these questions is voluntary.

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* 1. What is your Name (First and Last)?

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* 2. What is your age?

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* 3. What is the County in which you live?

Addison

Bennington

Caledonia

Chittenden

Essex

Franklin

Grand Isle

Lamoille

Orange

Orleans

Rutland

Washington

Windham

Windsor

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* 4. What is the best way to contact you?

Email:

Phone:

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* 5. Parent/Guardian Name:

Best way to contact parent/guardian (please include email and/or phone information):

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* 6. I am a (choose all that apply):

High school or homeschool student

High school/tech school/ homeschool graduate

College/ Training student

Employed

Other (Please, specify)

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* 7. Are you connected to HireAbility VT (formerly Vermont Vocational Rehabilitation) or Vermont Division for the Blind and Visually Impaired (DBVI)? If so, please list the name of your Counselor:

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* 8. Tell us a little about yourself. People say that you are good at:

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* 9. Why do you want to join the council?

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* 10. Is there anything that you would like to change in your school, community, or county? Name it/them.

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* 11. How did you hear about us?

Through my HireAbility or DBVI counselor

Through VCIL Youth Transition Program

Through my School

Other (Please specify)

VT Youth Advocacy Council Application

BE A LEADER AND A CHANGE MAKER!!!

Question Title

* 1. What is your Name (First and Last)?

Question Title

* 2. What is your age?

Question Title

* 3. What is the County in which you live?

Question Title

* 4. What is the best way to contact you?

Question Title

* 5. Parent/Guardian Name:Best way to contact parent/guardian (please include email and/or phone information):

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* 6. I am a (choose all that apply):

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* 7. Are you connected to HireAbility VT (formerly Vermont Vocational Rehabilitation) or Vermont Division for the Blind and Visually Impaired (DBVI)? If so, please list the name of your Counselor:

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* 8. Tell us a little about yourself. People say that you are good at:

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* 9. Why do you want to join the council?

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* 10. Is there anything that you would like to change in your school, community, or county? Name it/them.

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* 11. How did you hear about us?

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* 12. Is there anything else you would like us to know about you?Thank you very much!

* 5. Parent/Guardian Name:

Best way to contact parent/guardian (please include email and/or phone information):

* 12. Is there anything else you would like us to know about you?

Thank you very much!