Habitat Youth Leadership Council 2016/17 Question Title * 1. Please provide your contact information below. Name: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. What school do you attend? Question Title * 3. Current Experiences. Are currently involved with a service club or activity (school or church)? Yes No Question Title * 4. Please tell us about the clubs/service activities you are currently involved in. If you are not currently involved in a club or activity, but have been in the past, please list those with the years you were involved. Question Title * 5. Please rank your interest in the options below.1- None2- Some3- Most Interest 1 2 3 4 Fundraising 1 2 3 4 Marketing 1 2 3 4 Community Outreach 1 2 3 4 Working with Youth Next