UNITY Individual Membership Renewal
This form is for to update your existing membership as an Individual.
(Note: there is a separate form if you are a New Member visit www.unityinc.org/Membership)

To Renew your Individual UNITY Membership:
1. Complete this online form
2. Pay Annual Membership Dues: $50.00- Due by June 30th of each year.

Individual membership requirements
American Indian, Alaska Native or Native Hawaiian
14-24 years of age

This year, UNITY has standardized the report into an easy-to-use online form. This form will allow individual members to submit updated contact information and important highlights of all the great things that UNITY youth are doing across the nation. Please take time to review the form and collect the necessary information.

Remember to be in "Good Standing" as a voting member of the National UNITY Council, to run for the NUC Executive Committee, and/or have voting rights at the Biannual Business Meetings, this report must be filled out along with your paid annual affiliation fee by June 30th of each year.

Call UNITY Headquarters if you have any questions: 480-718-9793 or contact LorenAshley at la.buford@unityinc.org

Name *
Email Address *
Do you participate or volunteer with a local Youth Council? If so, please list their name:
Where do you call home? *
I am affiliated with the following American Indian Tribal Nation: *
If possible, please upload a photo of yourself
Current Age *
I identify as
Please provide the following information about your academic, work and volunteer activities. If you don't know, just type in "0". Estimates are okay to include so give it your best guess. *What is your Average GPA: *
Did you graduate from high school this year? *
Are you attending college this year? *
Did you graduate from college this year? *
Do you have a full or part time job, internship or apprenticeship? *
Are you currently serving in the military? *
Do you have an individual Wellness Warrior Action Plan completed or a Community Action Plan developed? *
How many hours this last year did you spend on Community Service? *
How many hours this last year did you spend on Fundraising? *
How many hours this last year did you spend on Activity planning? *
Please Share information below to describe (and upload pictures or documents) that highlight up to three (3) important activities that you participated in the last year. * How many events did you personally help host? *
ACTIVITY #1 Information: Name of event *
ACTIVITY #1 Information: Date *
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ACTIVITY #1 Information: Location *
ACTIVITY #1 Information: Number of Attendees *
ACTIVITY #1 Description *
Which of the four areas of UNITY did this activity address? *
ACTIVITY #1 Photo Upload
_______________________________________________________________ ACTIVITY #2 Information: Name of event
ACTIVITY #2 Information: Date
MM
/
DD
/
YYYY
ACTIVITY #2 Information: Location
ACTIVITY #2 Information: Number of Attendees
ACTIVITY #2 Description
Which of the four areas of UNITY did this activity address?
ACTIVITY #2 Photo Upload
_______________________________________________________________ ACTIVITY #3 Information: Name of event
ACTIVITY #3 Information: Date
MM
/
DD
/
YYYY
ACTIVITY #3 Information: Location
ACTIVITY #3 Information: Number of Attendees
ACTIVITY #3 Description
Which of the four areas of UNITY did this activity address?
ACTIVITY #3 Photo Upload
If you have additional activities you would like to share, please email la.buford@unityinc.org to be featured in UNITY's newsletter.
In the last 12 months, how well has UNITY met the following project goals and objectives for the Wellness Warriors (WW) project? *Reminder: Many youth engaged in WW training at the 2018 Mid-Year conference and also downloaded the free mobile app during the 2017 NationalUNITY conference. *
The WW project has fostered mental, physical, spiritual, and social development of Native youth. *
Low/Not at ALL True
Always True
The WW project has helped me learn more health and wellness skills, knowledge, and behaviors *
Low/Not at ALL True
Always True
The WW project has helped youth to create and track personal wellness goals on the mobile app. *
Low/Not at ALL True
Always True
The WW project has supported UNITY communities and youth councils to create community wellness action plans. *
Low/Not at ALL True
Always True
The WW project helps create community action plans that are meaningful, engaging, and important. *
Low/Not at ALL True
Always True
The WW project has helped me to feel comfortable writing a community action plan. *
Low/Not at ALL True
Always True
The WW project helps me to feel strong in my ability to be a leader in my own community wellness projects. *
Low/Not at ALL True
Always True
The value and use of UNITY and WW project resources, materials, and people has increased. *
Low/Not at ALL True
Always True
People in my community are more aware about the UNITY WW project. *
Low/Not at ALL True
Always True
Other youth I know are more aware about the UNITY WW project. *
Low/Not at ALL True
Always True
The value and use of UNITY and WW project resources, materials, and people has increased. *
Low/Not at ALL True
Always True
I see or hear more about UNITY and the WW project through social media, newsletters, or other virtual spaces. *
Low/Not at ALL True
Always True
I would love to see UNITY and the WW project do more outreach in person within my community, state, or regional area. *
Low/Not at ALL True
Always True
What are the top challenges/issues facing Native youth, in your community, that need to be addressed in the next 12 months? *
What are your youth council's plans or ideas to address these challenges/issues locally, in the next 12 months? *
In the next 12 months, how can UNITY and the WW project support you to address these challenges/issues or other topics? Please be descriptive and ask away! *
In the next 12 months, what topics or activities would you like UNITY to host webinars on? Are there specific presenters or people would you like to see? Please be detailed, UNITY will use this information to plan future WW project activities. *
Video: "Spreading the Good News"This year we are asking youth councils to provide a link to a short video of the youth explaining an event they have hosted this year. Submitted videos will be considered for 2019 Midyear Conference registration scholarships. Please provide the following information with the video: Video link: Who?: What?: When?: Where?: Why important?:
Please share any other helpful comments or suggestions that this survey may have missed.
Thank you for participation in our survey. To show our appreciation, we are going to randomly select eight $25 Amazon gift card winners. If you would like to be entered into this drawing, please enter your contact information below. First and last name, Mailing address to send the card, E-mail address & Telephone
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