This application should be completed by the child that is applying to train in the Jr. Youth Ambassador Program (Jr. YA) and an adult Parent/Legal Guardian. If selected for the program, the Jr. Youth Ambassador will travel with an Adult Team Member to training.
Please note the following requirements for the Junior Youth Ambassador Training:

The Jr YA Program is for children ages 7-11. Children must be at least seven years of age by March 2nd, 2027. Children applying to the Jr YA Program must have a diagnosis of Tourette Syndrome (TS) or another Tic Disorder (TD) OR have a sibling or other relative that has a diagnosis. Children need to be prepared to learn about TS and ready to become strong self-advocates.


Learn more about the TAA Jr. Youth Ambassador Program.
Note: Please be aware that funding for this program is granted to individuals living in the United States. If you are interested in this program and you live outside of the United States, you have the full responsibility for paying for travel, hotel, and meals.
Demographics

Question Title

1. First Name (Required.)

Question Title

2. Last Name (Required.)

Question Title

3. Date of Birth (Required.)

Date

Question Title

4. Please enter the age you will be on March 2, 2027. (Required.)

Question Title

5. Please specify applicant's sex. (Required.)

Question Title

6. Please specify applicant's race. (Required.)

Question Title

7. Address (Required.)

Question Title

8. Address Line 2

Question Title

9. City (Required.)

Question Title

10. State (Required.)

Question Title

11. Zip Code (Required.)

Question Title

12. Email Address (Required.)

Question Title

13. Phone Number (Required.)

Question Title

14. Grade Level (Required.)

Additional Information About Applicant

Question Title

15. How did you hear about the TAA Jr. YA Program? (Required.)

Question Title

16. Do you have a diagnosis of TS? (Required.)

Question Title

17. Do you have a sibling, family member, or friend that is a Youth Ambassador, Rising Leader, or Jr. YA? If so, what is their name and what year were they trained?

Question Title

18. Do you feel comfortable telling others that you have TS or a Tic Disorder? (Required.)

My Story - In the space below, please tell us in your own words why you want to be a Jr. YA and what being a Jr. YA means to you.

Include in your essay:

o Your name, age, and the state where you live.
o Share an experience telling someone about your Tourette Syndrome (TS) or Tic Disorder or explain what you wish others knew about living with TS or a Tic Disorder.
o What are you most looking forward to if chosen to be a Jr. YA?
o Anything else you’d like us to know about you.

Parameters of your story:

o One to two paragraphs (each paragraph being 3-5 sentences)
o Please write your story below. Your story should be 125-150 words. (This is the equivalent to half a page and can be either single or double spaced).

Speech-to-Text:
If you need assistance completing this application, there are free speech-to-text tools available that may help you fill in the blanks for the written portions of this application.

o Aiko: https://sindresorhus.com/aiko
o Whisper: https://www.usewhisper.io/
o Google Docs Voice Typing: https://support.google.com/docs/answer/4492226

Note: Your story will be shared in a 2027 Jr. YA Storybook. Please check your spelling and grammar. Jr. YA stories will be kept as close to the original as possible; however, some editing may occur for the purpose of publication, and the final product may not be in the same format or contain all of the components submitted.

Question Title

19. My Story (125-150 words) (Required.)

Question Title

20. Photo (Required.)

*Stories and photos must be submitted at the time of application. A completed story and submitted photo are required for the applicant to be considered for an interview with the TAA. The interview is the next step in the Junior Youth Ambassador application process.
Letter of Recommendation (Optional)

We’d love for someone (age 18+) who knows you well to share why you’d be a great fit for the 2027 TAA Jr. YA Program. Letters of Recommendation can be from a coach, teacher, community leader, medical provider, mentor, and more.

Please have the identified adult send their letter of recommendation to ya@tourette.org. Be sure to include the candidate’s first and last name in the subject line.
Questions For Adult Team Member (Parent/Legal Guardian or Designated Support Adult)

Question Title

21. Adult Team Member First Name (Required.)

Question Title

22. Adult Team Member Last Name (Required.)

Question Title

23. Adult Team Member Email Address (Required.)

Question Title

24. Adult Team Member Phone Number (Required.)

Question Title

25. What is your occupation and place of employment?

Question Title

26. Please share the applicant's primary language. (Required.)

Question Title

27. What is your family’s preferred language for communication? (Required.)

Question Title

28. Does the applicant or Adult Team Member require language/material accommodations to participate effectively? (i.e. American Sign Language, Larger Text, Captions, etc.) (Required.)

Question Title

29. Does your family belong to a local TAA Chapter or TAA Support Group? (Required.)

Question Title

30. Does your family have any previous involvement with a TAA Chapter and/or TAA Support Group? If so, please describe.

Question Title

31. Has your family been involved in any Tourette Association of America activities or events? If so, please list the event(s) and what your involvement was.

Question Title

32. If selected, will the Junior Youth Ambassador applicant and/or Adult Team Member be attending with any mobility aids or accessibility supports?
(Examples may include a cane, walker, wheelchair, service dog, etc.)

Note: This information does not impact the application selection process. It is only used to help our team prepare for accessibility and support needs during the event. (Required.)

Question Title

33. If selected, will the Junior Youth Ambassador applicant and/or Adult Team Member have any dietary needs, food allergies, or meal accommodations our team should be aware of?

Note: This information does not impact the application selection process. It is only used to help our team prepare for accessibility and support needs during the event. (Required.)

Question Title

34. I have read the application in its entirety and understand the time commitment to prepare and train for the Jr. YA Training & Program. I also understand that my child and I are then committed to being involved with the TAA post-training. Please initial. (Required.)

Question Title

35. If this application is accepted and my child is selected to attend Jr. YA Training at the Hilton Alexandria Mark Center in Alexandria, VA. I understand that, as the Adult Team Member who will be chaperoning my child, I am responsible for supervising my child at all times, including the time my child spends at the Hilton Alexandria Mark Center and if/when my child leaves the hotel for any reason including to attend Tourette National Advocacy Day on Capitol Hill. The event is being held in Washington D.C., as such, my child and I need to be aware of our surroundings at all times when outside of the hotel. Please initial. (Required.)

Media Participation Release

I hereby irrevocably grant to the Tourette Association of America and to its employees, agents, and assigns, the right to photograph and/or video record and use pictures, silhouettes, videos and other reproductions of me and/or my children's physical likeness (including potentially televised both locally and nationally) for educational, informational, promotional, charitable, and fundraising activities for the Tourette Association of America and its Chapters and Support Groups and inclusion on, but not limited to the Tourette Association of America's website, YouTube channel, and all other social media sites. I hereby certify and represent that I have read the foregoing and fully understand the meaning and effect thereof and, intending to be legally bound, I have hereunto set my hand.

Question Title

36. I agree to the Media Participation Release. Please initial. (Required.)

Question Title

37. I give permission for my child's picture and name to be used by the Tourette Association of America as a Jr. YA in any and all publications. Please initial. (Required.)

Question Title

38. I grant permission to the Tourette Association of America to use and share my child's name, state, and likeness. Please initial. (Required.)

Question Title

39. I have read over the requirements to be a Jr. YA in this application and am aware that my child is applying to be trained as a Tourette Association of America Jr. YA. Please initial. (Required.)

Question Title

40. I understand and agree that the applicant cannot repeat a level of training and must be aged 7-11 for the training on March 2, 2027. Please initial. (Required.)

Question Title

41. If the applicant is accepted into the Youth Ambassador Program, I understand that all Adult Team Members attending or participating in the program are required to complete a TAA background check. Please initial. (Required.)

Question Title

42. I understand and agree that both the Junior Youth Ambassador applicant and Adult Team Member are expected to attend the required Zoom meeting on a date to be determined in December prior to the Ambassador Training to review important program information and event expectations. Please initial. (Required.)

Question Title

43. I have read and agree to the TAA Event Terms and Conditions. Please initial. (Required.)

Question Title

44. I want to learn about upcoming TAA events and initiatives via email. (Required.)

Question Title

45. Adult Team Member, please sign by typing your full name. (Required.)

T