Youth Advisory Council Application Please fill out this form if you are interested in serving on Second Story's Youth Advisory Council! Name:* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last How old are you?*Please enter a value between 13 and 21.Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address:* Phone Number:*I prefer to be contacted by...* Email Phone What school do you attend and what grade are you in?*Emergency Contact Name:* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Emergency Contact Phone Number:*How did you learn about Second Story?*--SELECT ONE--Friend, community member, or word of mouthDrove by and saw your signI received services from the organizationOnline or social mediaNewspaper, radio, or print materialsOther/I don't rememberWhy do you want to be a Youth Council member at Second Story?*Please describe any past volunteer experiences.*Are you willing to commit to at least one full school year of service?* Yes No Have you ever been convicted of a crime?*YesNoIf yes, please explain.*Let's keep in touch! Yes, please keep me updated on Second Story news. NameThis field is for validation purposes and should be left unchanged.