Mentis Teen Council Application 2022/2023
Please answer all questions to your best ability so that we can get a full understanding of you as a person.

Requirements to be on Teen Council

- Attend our monthly Teen Council meetings (the first Tuesday of every month from 7:00-8:30pm)
- Participate in additional activities and events planned by our council that focus on caring for self, others and the community.
- Complete a QPR suicide prevention training (provided by Mentis staff)
- Be an advocate for mental health and wellness in your peer community

IF YOU HAVE TROUBLE SUBMITTING THIS APPLICATION, PLEASE EMAIL NYAH MCWILLIAMS, PREVENTION SPECIALIST AT nmcwilliams@mentisnapa.org
Name (First and Last) *
Pronouns
Grade (2022/2023) *
Required
School *
Required
Ethnicity
Gender
Sexual Orientation
Religion
How did you hear about our Teen Council? *
Have you been to any of our events before? If so, which one(s)? *
How has depression, anxiety, or a mental illness affected you personally or someone you know/love? *
Have you had any experience in volunteer work? If so, please share. *
What are some of your hobbies or passions? *
What clubs or groups are you a part of in your school or community? *
As a member of Teens Connect, what would you like to bring to the council? *
Please submit the name and email of at least one peer or adult reference - current council members, teachers, school admin, coaches, bosses, family/friends that are familiar with your work ethic, passion, and personality. *
Phone Number
Address (This will be used if admitted to the Teen Council. Feel free to leave blank for now if you don't feel comfortable sharing.)
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