Skip to content

Citrus Family Care Network Youth Advisory (YAC Nomination Form)

Our YAC Vision: To develop and sustain a youth-adult partnership, positive youth development, youth-led feedback, and equity-centered practice.

Why do we have a YAC: Youth offer important perspectives for understanding the context of data, uncovering barriers to progress, and identifying strategies for improvements. Primary Stakeholders, like former and current youth, may also have additional data that may promote further understanding.
1.Name of Youth:(Required.)
2.DOB or Age:(Required.)
3.Contact Number:(Required.)
4.Additional Contact Number (if applicable):
5.Email Address:(Required.)
6.What is your preferred way of contact?(Required.)
7.Are you nominating the youth/young adult for BIG YAC (Under 18)?(Required.)
8.Are you nominating the youth/young adult for YAC (Over 18)?
9.Do you have any barriers to attend monthly meetings?(Required.)
10.Strengths of Youth (Select that all apply):(Required.)
11.What areas do you want to improve on? (Select that all apply):(Required.)
12.Name of Person Nominating Youth:(Required.)
13.If you are not self-nominating, Is the youth/young adult aware of this nomination?