Youth Advisory Council Member Application
If you have any questions, please contact:
Bill Lentz, YAC Advisor 
Amanda Bruner, Program Manager
217 N. Washington Street, Suite 104 ● Owosso, MI 48867 ● (989) 720-7441

Name *
Address *
City *
State *
Zip Code *
Cell Phone *
Other Phone
Personal Gmail *
School *
Graduation Year *
Parent/Guardian Name *
Parent/Guardian Phone # *
Parent/Guardian Email
Parent/Guardian Name
Parent/Guardian Phone #
Please tell us why you want to join the YAC: *
What skills or characteristics will you bring to the YAC? *
What are your interests, hobbies, activities? *
What issues facing youth in our community do you think need the most attention right now? Examples include but are not limited to: bullying, poverty, hunger, afterschool programs, unsafe home environments, health education, teen pregnancy, access to education, drug abuse,  and social activities in the area. *
The YAC meets once a month during the school year (usually at 2:00 on the 2nd Sunday of the month). Are you able to commit to monthly meetings and at least three volunteer activities per year? *
What is the best way to contact you? *
There is an additional form for parents/guardians and applicants to sign and return regarding a driving release, media release, and medical release. Would you prefer this form be emailed or mailed for you to return it to Shiawassee Community Foundation? *
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