Participant Advisory Council Application 2023-2024

Thank you for your interest in NWA's WIC Participant Advisory Council! If you have any questions as you are completing this application, please reach out to Whitney Dawn Carlson, NWA's Recruitment & Retention Campaign Senior Manager, at wcarlson@nwica.org.

Participant Advisory Councilmembers will serve as consultants to NWA by providing their expertise on the WIC experience in order to advocate for new program and policy priorities and recommendations. Potential members will be able to learn about the political process, engage in policy, and virtually connect with a cohort composed of other participants from across the country. The Participant Advisory Council is a chance for WIC participants to have their voices heard and represent WIC participants across the nation.

In order to be eligible to serve on the Participant Advisory Council, applicants must:

Commit to serving on the council for at least one year
Have participated in WIC for at least six months
Be a current/former participant in the WIC program OR the caretaker of a former/current WIC participant
Not be a current employee of the WIC program

Please note that members of the Participant Advisory Council will receive compensation for their participation ($25/hour), individual membership in NWA, and complementary virtual NWA conference registration.

You are able to save and resume your application at a later time. If you have any trouble accessing your application, please email Whitney Dawn Carlson at wcarlson@nwica.org.

1. What is your first and last name? *This question is required.

2. What is the best email address to reach you at? *This question is required.

3. What is the best phone number to reach you at? *This question is required.

4. What state or US territory do you live in? *This question is required.

5. What city or county do you live in? *This question is required.

6. Please list your zip code. *This question is required.

7. How would you best describe the area you live in? *This question is required.

8. What category(s) best describe you? Please select all that apply. *This question is required.

American Indian or Alaska Native
Asian
Black or African-American
Hispanic, Latino, or Spanish Origin
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Other Please enter an 'other' value for this selection.
Prefer not to respond

9. Please select your preferred pronouns. *This question is required.

Please enter an 'other' value for this selection.

10. Are you a current or former caretaker of a WIC participant? *This question is required.

11. How many children that you care for currently or formerly participated in WIC? *This question is required. This question requires a valid number format.

11. Are you personally a current or former WIC participant? *This question is required.

12. What was the most recent month and year that you OR your child participated in WIC? *This question is required.

13. Were you formerly employed by a WIC State Agency, Local Agency, Indian Tribal Organization (ITO), or other WIC organization?* *This question is required.

No
Yes, WIC state agency
Yes, WIC local agency
Yes, Indian Tribal Agency
Yes, other: Please enter an 'other' value for this selection. * This question is required.

14. Have you served as a WIC Breastfeeding Peer Counselor? *This question is required.

15. Please write a few sentences about your overall WIC experience. *This question is required.

16. In what ways has WIC helped your family? *This question is required.

17. What frustrations, challenges, or barriers do you see or have personally experienced while participating in WIC? *This question is required.

18. What is your ideal vision for the WIC program? Please include a brief statement below.
*This question is required.

19. Why do you want to serve on the Participant Advisory Council?* *This question is required.

20. How did you hear about this opportunity? *This question is required.

Local WIC agency/clinic staff
State WIC agency staff
Social media
National WIC Association's Monday Update
National WIC Association Website
Other: Please enter an 'other' value for this selection. * This question is required.

21. Are you available to meet virtually at either of the following days/times?" *This question is required.

Last Thursday of every month, 12-1:30pm ET
Last Thursday of every month, 7-8:30pm ET
No, I am not available at the above days/times

22. What days of the week and times work best for your schedule for virtual meetings? *This question is required.