Please complete and sign this application, and don't forget to have your Adult Team Member (Parent/Legal Guardian or Designated Support Adult) sign as well. This application must be completed by the Youth Ambassador (YA) applicant.
Please note the following requirements for the Youth Ambassador Training:

Teens ages 12–17 can train to be Youth Ambassadors. Teens must be at least 12 years of age by March 2nd, 2027. They may or may not have a diagnosis of Tourette Syndrome (TS) or another Tic Disorder (TD). Youth Ambassadors must participate with a supportive adult who will assist with presentations, scheduling, and outreach activities. Youth Ambassadors should have an interest in learning more about TS and TD, helping others understand these conditions, and sharing their experiences through advocacy and education efforts.

Learn more about the TAA 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

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1. First Name (Required.)

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2. Last Name (Required.)

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3. Date of Birth (Required.)

Date

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4. Please enter the age you will be on March 1, 2027. (Required.)

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

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

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7. Address (Required.)

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8. Address Line 2

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9. City (Required.)

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10. State (Required.)

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11. Zip Code (Required.)

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12. Email Address (Required.)

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13. Phone Number (Required.)

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14. Grade Level (Required.)

Additional Information

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15. How did you hear about the TAA Youth Ambassador Program? (Required.)

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

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17. Are you a Junior Youth Ambassador? (Required.)

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18. If yes, what year were you trained?

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

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20. Do you feel comfortable speaking in front of an audience? (Required.)

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21. Do you belong to a local TAA Chapter or TAA Support Group? (Required.)

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22. Do you have any previous involvement with a TAA Chapter and/or TAA Support Group? If so, please describe.

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23. If applicable, please include links to any news media or articles written about you, or a video of you educating about TS.

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24. Have you been involved in any Tourette Association activities or events? If so, please list the event(s) and what your involvement was.

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25. Have you ever organized or led any school clubs, school events, or community events? If yes, please list the event(s) and describe your involvement.

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26. Have you been involved in any community service? If so, please list the name and your involvement.

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27. Describe a time you overcame a problem or difficult time and what helped you overcome it. (Required.)

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28. What type of social event would you be most interested in participating in with other Youth Ambassadors outside of training sessions?

(Examples from past years have included hotel social hours, game rooms, movie/game nights, and DJ/dance parties.) (Required.)

My Story - In the space below, please write an essay focused on your Tourette Syndrome journey. In this essay, reflect on your journey with TS and what TS has meant to you in your own personal lived experience.

Include in your essay:

o Do you or does someone you know have a diagnosis of TS or a Tic Disorder?
o What qualities would make you a strong Youth Ambassador candidate?
o What would you like to achieve as a Youth Ambassador for the TAA?
o How do you plan to stay connected to the TAA and the cause of advocating for the TS & Tic Disorder community after this training?
o Anything else you think is important for us to know.

Parameters of your story:

o Please write your story below. Your story should be 250-500 words. (This is the equivalent of one page 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 Youth Ambassador Storybook. Please check your spelling and grammar. Youth Ambassador 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.

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29. My Story (250-500 words) (Required.)

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30. 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 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 Youth Ambassador Program. Letters of Recommendation can be from a coach, teacher, community leader, medical provider, mentor, and more.

Please have the identified Adult Team Member 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)

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31. Adult Team Member First Name (Required.)

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32. Adult Team Member Last Name (Required.)

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33. Adult Team Member Email Address (Required.)

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34. Adult Team Member Phone Number (Required.)

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35. What is your occupation and place of employment?

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

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37. What is your family's preferred language for communication? (Required.)

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

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

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

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40. If selected, will the 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.)

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41. I have read the application in its entirety and understand the time commitment to prepare and train for the Youth Ambassador Training & Program and the requirements to remain a Youth Ambassador after training. Please initial. (Required.)

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42. If this application is accepted and my child is selected to attend Youth Ambassador Training at the Hilton Alexandria Mark Center in Alexandria, VA, I understand that, as the parent/adult guardian who will be chaperoning my child, I am responsible for supervising my child at all times. This includes while my child is at the Hilton Alexandria Mark Center and whenever my child leaves the hotel for any reason, including while attending Tourette National Advocacy Day on Capitol Hill. Because the event is being held in Washington, D.C., my child and I understand the importance of remaining aware of our surroundings at all times, both inside and 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.

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

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44. 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.)

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

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

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47. I understand and agree that the applicant cannot repeat a level of training and must be aged 12-17 for the training on March 2, 2027. Please initial. (Required.)

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48. 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.)

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49. I understand and agree that both the 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.)

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

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

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

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