Youth Advisory Committee (YAC) Application

Clio, Countywide, Grand Blanc, and South Lakes

The mission of YAC is to empower young people, involve them in the community, and teach them about philanthropy while serving as stewards through granting.
Membership in YAC is open to any Genesee County high school student interested in serving their community and willing to volunteer their time.

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* 1. What is Your Full Name (First, Last)?

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* 2. What is Your Preferred Nickname?

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* 3. What is Your Date of Birth? (MM/DD/YYYY)

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* 4. How Do You Identify Your Race or Ethnicity?

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Another Race/

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* 5. How Do You Identify Your Gender?

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* 6. What are Your Preferred Pronouns?

He/Him/His

She/Her/Hers

They/Them

Prefer Not to Answer

Other (please specify)

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* 7. What is the Name of Your High School?

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* 8. What Grade will You Enter in the 2023 - 2024 School Year? (9th, 10th, 11th, 12th)

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* 9. Please Provide Your Contact Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 10. Please Enter Your Parent's Contact Information.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 11. What is Your Favorite School Subject and Why?

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* 12. Are You Involved in any Extra-Curricular Activities? If so, please list them.

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* 13. What is Your Favorite Activity and Why?

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* 14. YAC meets monthly during the school year. One of the responsibilities of being on the YAC is attending the meetings. Can you attend monthly meetings?

Yes

Youth Advisory Committee (YAC) Application

Clio, Countywide, Grand Blanc, and South Lakes

Question Title

* 1. What is Your Full Name (First, Last)?

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* 2. What is Your Preferred Nickname?

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* 3. What is Your Date of Birth? (MM/DD/YYYY)

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* 4. How Do You Identify Your Race or Ethnicity?

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* 5. How Do You Identify Your Gender?

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* 6. What are Your Preferred Pronouns?

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* 7. What is the Name of Your High School?

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* 8. What Grade will You Enter in the 2023 - 2024 School Year? (9th, 10th, 11th, 12th)

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* 9. Please Provide Your Contact Information

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* 10. Please Enter Your Parent's Contact Information.

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* 11. What is Your Favorite School Subject and Why?

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* 12. Are You Involved in any Extra-Curricular Activities? If so, please list them.

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* 13. What is Your Favorite Activity and Why?

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* 14. YAC meets monthly during the school year. One of the responsibilities of being on the YAC is attending the meetings. Can you attend monthly meetings?

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* 15. How Did You Hear About YAC?

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* 16. What about the Youth Advisory Council caught your attention and why do you want to join?

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* 17. Do you currently volunteer? What types of things and organizations do you volunteer for?

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* 18. Recognizing that everyone has a busy schedule, what possible conflicts might prevent you from attending meetings?

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* 19. Signed:

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* 20. Date (MM/DD/YYYY):