Youth Outreach Squad (YOS) Application 2020
YOS offers youth ages 12-16 comprehensive mental and physical health outreach training. Youth have the opportunity to learn about topics such as STI and HIV prevention, nutrition, reproductive health, health relationships and project and planning implementation. Youth then act as agents of change, taking information learned throughout the program to conduct community outreach via social media and tabling events. Participants will earn a stipend for the duration of the program.

Applications for YOS are due Friday, January 17th, 2019 @5:00 PM
YOS members begin Monday, February 10th, 2019 @5:00 PM
Upon application submission, scheduled interview slots will be assigned

Applications can be submitted via in-person, email or online
Ashia Coleman
1728 Bancroft Ave
San Francisco, CA 94124

Participant Expectations:
Must attend all health education workshops
Help educate youth and community members through outreach activities including tabling events, workshops, and street outreach.
Youth is responsible for keeping up with administrative work assigned to projects, classes, workshops, and outreach. Example= flyers, sign in sheets, final project

Youth must be 12-16 years’ old
Youth must commit to 3 days a week, Monday-Wednesday, from 5-7 PM as well as a few special occasions outside their normal hours (weekends, holidays, events, festivals, etc.)
Youth must commit to full 12 week semester
Youth must have an interest in health advocacy and community outreach

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Email *
Email Address *
Applicant Information
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Full Name (First & Last) *
Preferred Name
Street Address *
City *
State *
Zip Code *
Date of Birth *
Cell phone number (Best number to be contacted) *
Have you ever participated in YOS before? *
If so, which session?
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Name of Middle School & years you have attended *
If in high school, name of high school you attend and grade level
Applicant Questionnaire
Please complete this to the best of your abilities. Your responses are important upon submitting your application. You must write at least two sentences for each question.
Are you interested in learning about health topics? *
Tell us about your yourself: (Hobbies, talents, things you are interested in, etc.) *
Describe an issue in your community & what changes you would like to make or see? *
As of youth, what does having a voice means to you? *
What do you know about the services at 3rd Street Youth Center & Clinic? *
Why are you interested in joining YOS at 3rd Street? What do you want to gain from this program? *
Disclaimer & E-Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to program enrollment, I understand that false or misleading information in my application or interview may result in my release from programming.
Enter your initials to serve as your e-signature *
A copy of your responses will be emailed to the address you provided.
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