Moffat County Youth Action Council 20/21 Application
"MCYAC's vision is of a community in which teens have a voice in social, political, and environmental issues.
Our mission is to raise awareness of issues important to teens and enable their voices to be heard, providing solutions and fresh, innovative ideas. As leaders amongst our peers, we exemplify that teens are committed to education, health/wellness, the environment and community service."

As a member of MCYAC, YOU will be responsible for working with your peers to create change in your community. The adult facilitators will help you gain the activism knowledge, skills, and opportunities you need to make a difference.

We believe in safe, supportive, and engaging spaces for all identities, where you can find fellowship and connect to like-minded peers.

Eligibility:
- Must be in grades 8-12 during the 20/21 school year
- Must be either a resident or school attendee in Moffat County
- Must have or be willing to work on good communication skills
- Must be committed to working well with diverse peers
- Must be action-oriented and eager to learn & grow!

For any question, please contact Megan Smith at MSmith@northwestcoloradohealth.org or Noah Bumenberg at moffatcounty@grandfutures.org.
Name *
Birthdate *
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Email address *
Phone number *
Mailing address
School you attend *
Grade for the 20/21 school year *
Why do you want to join MCYAC? (50-150 words) *
What issues are you passionate about in your community? *
What strengths do you think you would bring to this group?
What other extracurricular activities or clubs do you participate in?
Emergency Contact 1: Name, Phone, and Email Address of Primary Parent/Guardian *
Emergency Contact 2: Name, Phone, and Email Address of Primary Parent/Guardian
MCYAC meetings will be held either virtually or in person on most weeks throughout the year, including summer. Which of the following would work for you? Check all that apply. *
Required
If meetings are held in person in Craig, do you have access to reliable transportation on most afternoons/evenings?
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