AgriSafe Young Advisors Council (AYAC) Application Question Title * 1. Applicant Information Name Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 2. Date of Birth MM/DD/YYYY Date Question Title * 3. Parent/Guardian Information Name Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 4. Are you currently enrolled as a student? Yes, full time in graduate school Yes, part time in graduate school Yes, full time at a four year undergraduate college/university Yes, part time at a four year undergraduate college/university Yes, full time at a two year undergraduate college/university Yes, part time at a two year undergraduate college/university Yes, at a high school or equivalent No, I am not currently enrolled as a student Question Title * 5. What is the highest level of education you have completed? Did not attend school 1st grade 2nd grade 3rd grade 4th grade 5th grade 6th grade 7th grade 8th grade 9th grade 10th grade 11th grade Graduated from high school 1 year of college 2 years of college 3 years of college Graduated from college Some graduate school Completed graduate school Question Title * 6. What is the best method to reach you? Text Phone Email Question Title * 7. I currently participate in the following clubs/activities: Academic Extracurricular Community Volunteer (Briefly describe your role/title in the club/activity) Question Title * 8. Please describe why you would like to volunteer with AgriSafe Youth Advisory Council (AYAC). Question Title * 9. Please describe the type of agricultural work that you are currently involved in or plan to work in. (for example: agronomy,horticulture, animal sciences, livestock, crops) Question Title * 10. Name several key traits of an effective leader? Which one is the most important one to you? Explain why. (Be specific) Question Title * 11. How did you hear about AgriSafe Youth Advisory Council (AYAC)? FFA (State or National) 4-H Other (please specify) Done