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1. First Name (Required.)

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2. Last Name (Required.)

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3. Date of Birth (to be eligible for the JAC you must be between the ages of 17 and 25 years old) (Required.)

Date

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4. Address (Required.)

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5. Email Address (Required.)

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6. Cell Phone Number (Required.)

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7. Do you speak any languages other than English?

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8. How did you hear about the Juvenile Advisory Council?

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9. Please briefly describe how you have been involved with the juvenile justice system. Note: some level involvement is required to be eligible for the JAC) (Required.)

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10. Why are you interested in supporting justice-involved youth and their families? (Required.)

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11. How will you help us improve the juvenile justice system and the experience of youth and their families with the system? (Required.)

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12. Please describe a few situations where you used your leadership skills or inspired someone to make the right decision. (Required.)

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13. What do you wish someone had told you or done for you to prevent you from becoming involved with the juvenile justice system? Are you ready to convey that message to youth? (Required.)

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