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* 1. Name, Phone Number, and Email Address

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* 2. Name, Phone Number, and email of your Parent or Guardian

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* 4. City and State

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* 5. Write a brief statement on why you would like to be a member of 4 the Healing in You, Inc.'s Butterfly Advisory Board.

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* 6. Please describe experience(s) that you have that might have prepared you for this role (e.g. personal experience, employment, volunteering, leadership positions, clubs, etc).

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* 7. If you had to describe yourself in three words, what would they be?

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* 8. How would your friends and family describe you?

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