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MOST Advisory Committee Application
1.
Contact Information
Name
Organization/ Company Name
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
2.
Organization type
Community Based Organization 501(c)(3)
Public Library
Institution of Higher Learning
Local Government (Parks and Recreation)
Intermediate School District
Regional Intermediary
Youth (current or formal attendee)
Parent of participating student
Philanthropic Organization
Statewide Community Based Organization
A community or adult education program
Other
3.
What is your ethnicity? (Please select all that apply.)
American Indian or Alaskan Native
Arab or Middle Eastern
Asian
Black or African American
Latinx or Hispanic
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Other (please specify)
4.
Which of the following options most closely aligns with your gender?
Woman
Man
Non-binary/ Gender Fluid
Transgender
Prefer not to disclose
Other (please specify)
5.
What region of the state does your organization reside?
Southeast Michigan
South Central Michigan
West Michigan
Southwest Michigan
Northwest Michigan
Upper Pennisula
East Central Michigan
Northeast Michigan
East Michigan
Detroit Metro
6.
Experience, Knowledge, Skills (Check all that apply)
Youth Leadership
Program Management
Grant Writing
OST Work Experience
Youth Mentor
Youth Development
Volunteer
K-12 Educator Experience
OST Program Planning/ Curriculum
Youth Development
Program Assessments
External Evaluations
Program Enrichment Activities
Professional Development
Education Research
Program Provider/ Contracted Vendor
Community Advocate
Parent Advocacy
Community Organizing
Finance
Other (please specify)
7.
Why are you interested in joining the MOST Advisory Committee? Explain your experience and any areas of expertise in the OST Sector.
8.
The following meeting schedule is preliminary. Additional meetings may be added as needed. All meetings will be in-person to provide for active participation. A stipend and mileage reimbursement will be provided as needed.
August 11, 2023
October 6, 2023
December 8, 2023
February 9, 2024
April 12, 2024
June 14, 2024
August 9, 2024
Please respond for the best Friday time frame availability option:
Friday mornings
Friday afternoons
Other (please specify)
Current Progress,
0 of 8 answered