Youth Lay Health Worker Interest Form
What is GLOW?
Getting the Low Down on Wellness (GLOW) is a project funded by the Substance Abuse and Mental Health Services Administration  (SAMHSA) and the Minority Health Partnership. The objective of this project is to address Substance Use Disorders, Viral Hepatitis, and HIV on APIs (Asian, Pacific, and Islanders) youths and young adults from ages 18 to 24 years old living in Santa Clara County.

Each trainer will get a $250 gift card for their participation as an incentive for their participation and a chance to win a $10 dollars gift card for the participants who attend the presentation.

Who are we looking for?
We are looking to train youth and to become Youth Lay Health Workers that can present an hour workshop/presentation to peers and friends, classmates. The presentation is about educating youth on Substance use disorder, HIV/AIDS, and Hepatitis C.

How to become a Youth Lay Health Worker:
1. The first step is to fill out THIS INTEREST FORM
2. Each trainer is required to attend (1) 90 minute training session to learn how to present the GLOW workshop.
Each trainer must present this workshop to at least 10 other adults (18-24 yr old) in Santa Clara County.
3. Complete the Questionnaires both before and after training.

Age and demographics:
-Young Adults ages 18 to 24 years.
-Preferred Asian American/Pacific Islander identified people, but open to all.

For additional information or any questions please contact Kylie Paramore at
Today's date: *
First Name: *
Last Name: *
Age: *
E-mail: *
Phone: *
Gender Identity:
Race or Ethnicity:
I am interested in: *
Choose all that apply.
Tell us why you are interested in sexual health education?: *
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