New York State 2020 YMCA Youth Advocate Application
Please complete the application below to be considered as one of New York's nominees for the 2019 YMCA Youth Advocate Program at YMCA National Advocacy Days in Washington, DC from March 2-5, 2020.

Application Deadline: Tuesday, October 15, 2019
If you have any questions, please email dcaldwell@ymcanys.org
First Name *
Last Name *
Email Address *
Student Cell Phone # *
High School *
Grade *
Street Address *
Home Address
City *
State *
Zip Code *
U.S. Representative *
Who is your U.S. Representative in Congress? Please use your home address to determine your Congressional District: www.govtrack.us/congress/members/map
Gender *
Ethnicity *
Parent/Guardian Name *
Parent/Guardian Phone # *
Parent/Guardian Email Address *
Parent Confirmation *
By checking the box below, you acknowledge that your parent or guardian is aware of your application and your commitment if you are accepted.
Required
Emergency Contact Name *
Emergency Contact Phone # *
Medical Alerts or Allergies *
Dietary Restrictions *
Ex: Vegan, Vegetarian, Food Allergies, etc.
Program Information
Years in Y&G *
How many years have you participated in Youth and Government (including this one)
YMCA Teen Programs *
Are you a participant in other YMCA Teen Programs? Select as many as apply, and use the "Other" box to include any programs not listed
Required
Application Questions
Tip: It is safer to type and save your Application Responses as a file on your computer, then cut and paste your answers into each field below. This way you won't lose your responses if there is an internet connectivity issue!
Your Y Story *
As a Youth Advocate, you'll be expected to share a concise version of your Y story (how you joined your program, your role, and why the Y is important to you) with CEOs, Y Staff, and Public Officials during National Advocacy Days. Imagine you are sharing your Y story with a staff member in a Congressional office. (200 words or less).
Past Advocacy Experience *
Advocacy doesn't always require legislation or policymaking, but it always requires passion for the cause you are advocating. Describe an experience where you had to serve as an advocate for a cause or issue. This could be at school, in your community (or at the state/national level), at the Y, or as part of another organization. (200 words or less).
Policy Area of Focus *
The Y uses our three Areas of Focus to organize the issues we advocate for on the state and national level. Which Area of Focus mosts interests you?
Policy Interest *
What is one specific policy issue within the Area of Focus you specified that you would like to address? Why?
Thank You
Thank you for applying!
Submit
Never submit passwords through Google Forms.
This form was created inside of Kentucky YMCA Youth Association. Report Abuse