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Teen Advisory Board Application 2023

Teen Advisory Board Application 2023: Due 6/24/2023

The My Future- My Choice Program is currently seeking motivated teens across the state of Oregon who demonstrate a sincere desire to make a difference in their community and possess the right qualifications to serve on the Teen Advisory Board (TAB). Below you will find the Teen Advisory Board Online Application to apply to be a member of the 2023-2024 board. 

This application will ask you to list two adult references (name, phone number, and email), be sure to have those ready before starting your application. Adult references can include a My Future-My Choice Classroom Facilitator or Coordinator, a coach, youth/club leader, or teacher.

This form will not save responses as you type. If need to come back to the application later we suggest writing your response in a separate document and copying and pasting it into the survey box when you are ready to submit your application. 

Eligibility criteria for TAB membership is listed below. TAB members should:
  • Be a high school student during the 2023-2024 school year,
  • Have an interest in sexual health and equity,
  • Have the ability and desire to communicate well with peers, middle school students and adult staff,
  • Have the desire for leadership development, and
  • The ability and desire to advocate for youth sexual health and the My Future-My Choice program both at the community and state levels.
The Teen Advisory Board (TAB) acts as the youth voice of the My Future-My Choice program. TAB members are expected to give program feedback, advocate for youth sexual health and take part in leadership development activities. Members will connect monthly with an assigned local mentor, meet deadlines on a leadership project, participate in the virtual Leadership Kick-Off Weekend October 7-8, 2023 and the in-person End of the Year Meeting on April 5 -7, 2024 and connect by phone and/or electronic networking as necessary.

For in person events, MFMC will cover all overnight lodging, food, and transportation costs.

Please submit your Teen Advisory Board Application online by 5:00 pm June 24, 2023 by submitting this online form.

For more information visit: https://www.oregon.gov/dhs/children/mfmc/pages/index.aspx
For questions contact:

Andy Dettinger
andy.dettinger@odhs.oregon.gov
971-286-8090

-or-

My Future-My Choice Program Office
OR Department of Human Services
500 Summer St NE, E48
Salem, OR 97301
Fax: 503-373-7032
 
3. Can you receive mail addressed to this name? Should we use this name if talking to a guardian/caregiver? 
4. Basic Information *This question is required.
Sweatshirt Size (unisex)
8. Which of these do you have access to? (Select all that apply) *This question is required.
Have you ever been a Teen Leader? *This question is required.
List any activities you are involved in and how many hours per week each activity requires.
Space Cell ActivityWork/School/Community/SeasonalHours per week
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Will you be available to attend the mandatory virtual Leadership Kick-Off on October 7-8, 2023 (Saturday-Sunday, ~8:30-4:30 each day)?  *This question is required.
Will you be available to attend the mandatory End of the Year TAB Meeting on April 5 -7, 2024 (Friday-Sunday)? (Location TBD, all expenses covered) *This question is required.
Will you be available to meet for one hour monthly with a local mentor to work on TAB related activities? *This question is required.
Will you be available to meet for one hour monthly with the other TAB members to work on TAB related activities? *This question is required.
Is there a local adult (25 or older) that you have in mind to be your TAB Mentor? (A mentor is an adult in your community that you would meet with virtually an hour per month during the school year.  They would support you with the TAB project and also attend the two statewide meetings October 7-8, 2023 and April 5 -7, 2024. This person could be a My Future-My Choice Coordinator, a coach, or a youth/club leader.) *This question is required.
If yes please indicate:
10. List three attributes you would bring to the Teen Advisory Board? *This question is required.
First Adult Reference *This question is required.
Second Adult Reference *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
Application Signature *This question is required.
Clear
Signature of
Caregiver/Adult Support Person's Information
(Adult(s) you're living with i.e; parent, family member, resource parent, other)  *This question is required.
Is this person legally responsible for you?  *This question is required.
Legal Guardian Information
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