Fall 2019 Youth Leadership Team Interest Form
Introduction:
Our program is fueled by the leadership of youth & young adults that live in the communities we serve! Each semester we recruit interested and motivated youth to join our youth leadership teams (YLTs), which run in 6 month cycles with home-bases in Napa, Santa Rosa, Calistoga or Sonoma.

The YLT is a team of LGBTQ (lesbian, gay, bisexual, transgender, and queer) youth that create events and advocate for change in partnership with LGBTQ Connection. YLT gives youth the opportunity to learn how to be a part of a team and be community leaders. If you know a youth that would benefit from being on this team, nominate them. If you're a youth, apply yourself!

For questions about Napa & Calistoga (Napa County) teams, contact Stephanie Ramirez, stephanieodalise@lgbtqconnection.org or 707-251-9432.

For questions about Santa Rosa & Sonoma Valley (Sonoma County) teams, contact Reyanna Kipers, reyanna@lgbtqconnection.org or 707-241-3412.

Each team meets once a week for 5 intensive months. That intensity is what we’ve found that it takes to come together as a team and organize impactful projects and events for our community. These projects bring people together across generations and cultures to build a stronger, more vibrant, and more inclusive LGBTQ community.

Program Commitment:

For Fall 2019, participants will need to commit to the dates outlined in the interest form. If there is a schedule conflict, contact the program coordinator to determine if YLT is right for you. Any changes made to the dates listed will agreed upon with youth leadership team members during regular meetings. Secure a spot on the team & RSVP via the interest form. Those that fill out the interest form or contact the county program coordinators will be notified about next steps in the process.

So excited for you to join us!

Sincerely,
Reyanna Kipers and Stephanie Ramirez
Program Coordinators & Youth Leadership Team Coaches

Join us in creating LGBTQ Community!
First Name & Last Name *
Your answer
Gender Pronouns *
Birthday *
Your answer
Age *
Your answer
Are you in school? If so, what school? *
Your answer
Phone Number (with area code)
Your answer
Email Address *
Your answer
Home Address (street, city, zip code) *
Your answer
If you identify as LGBTQ+, are you out to your family? If for some reason we need to contact them, we want to respect your safety & privacy. *
Emergency Contact - First Name & Last Name *
Your answer
Emergency Contact- Relationship to You (Guardian, Social Worker, Family Member, etc.) *
Your answer
Emergency Contact- Phone Number (with area code) *
Your answer
Any Allergies, Medications, or other relevant Medical Information? *
Your answer
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