YOUTHNET • Youth Advisory Board Application YouthNet is a South Orange/Maplewood organization that's all about teens – what's for teens, what should be for teens, what's being said by teens. Youth Advisory Board is the teen group that is a part of YouthNet . It is made up of Middle and High School students, coming together to speak out for teens, and to work with other community members about teen issues. YAB's MISSION IS: To provide a voice for the youth of Maplewood and South Orange. To create change and bring forth new ideas To plan, promote, and implement programs and services for youth To be involved in your community YAB's REQUIREMENTS ARE: Grades 6 - 12 Resident of South Orange or Maplewood Must be able to attend monthly meetings Be willing to participate, voice your opinions, and work as part of a team Must submit an application by Monday October 1st, 2011. Applicant’s Name ____________________________________________________ Home address ______________________________________________________ Home phone _____________________ Cell phone ____________________ Applicant’s email address ______________________________________________ Parent's or Guardian's name ____________________________________________ School attending in fall 2011 _______________ Grade in fall 2011 ______ 1. List your skills, hobbies, or interests: (You may use the back of this paper if you need more room for any of these questions) 2. How or why would you like to help out in your community? 3. What do you think the youth of Maplewood/South Orange need or want? 4. YAB MEETINGS will be once a month at the public library. What time of day would be most convenient for you? Check as many times as apply: __ 3:30 pm __ 4:00 pm __ 6:00 pm __ 7:00 pm In addition, YouthNet meetings are on the 4th Tuesday of each month at 7:30 pm. YAB members are invited to attend these monthly planning meetings, but not required to attend. 5. REFERENCE FORM: Please pick one person who knows you well (not a family member) to serve as a reference for you. GIVE THEM THE REFERENCE FORM PAGE OF THIS APPLICATION & HAVE THEM RETURN IT TO US BY OCTOBER 1st. Write your reference's name and phone number here: name of reference phone number 6. TO THE STUDENT: I understand that I must commit some time to be on the Youth Advisory Board. I will attend all regularly scheduled meetings each month, as well as other scheduled subcommittee meetings/projects as set by the YAB. Student's signature Date 7. TO THE PARENT/GUARDIAN: I understand that my child is applying for a position on the Maplewood & South Orange Youth Advisory Board. I understand that the YAB is a one year commitment (Nov. 2007 – Oct. 2008). I will support my child if he/she is selected and assist them in getting to scheduled meetings and with projects they are working on. Parent's / Guardian's signature Date THIS YAB APPLICATION MUST BE SUBMITTED BY October 1st, 2011 TO: The CHS, MMS, or SOMS school library or: the Maplewood Public Library, 51 Baker Street, Maplewood, NJ 07040 or: the South Orange Public Library, 65 Scotland Road, South Orange, NJ 07079 For more information, please contact: Jane Folger at the Maplewood Library 762-1622 ext 5005 jfolger@maplewoodlibrary.org or Beth Halliday at the South Orange Library (973) 762-0230 bhalliday@sopl.org YOUTHNET Youth Advisory Board • Reference Form YouthNet is a South Orange/Maplewood organization that's all about teens – what's for teens, what should be for teens, what's being said by teens. Youth Advisory Board is the teen group that is a part of YouthNet. It is made up of Middle and High School students, coming together to speak out for teens, and to work with other community members about teen issues. YAB's MISSION is to: Provide a voice for the youth of Maplewood and South Orange; Create change and bring forth new ideas; Plan, promote, and implement programs and services for youth; Be involved in your community YAB's REQUIREMENTS are: Grades 6 – 12 and a resident of South Orange or Maplewood Must be able to attend monthly meetings, be willing to participate, and work as part of a team Applicant: Please give this form to a non-family member adult who knows you well. This could be a teacher, a mentor, a coach, or a neighbor. Please make sure they complete the form & submit it to us by October 1st, 2011. Reference: You were given this form because the applicant below is applying to join the YouthNet Youth Advisory Board. Your input and support of this person can help them to join the YAB. Applicant’s Name ____________________________________________________ 1. How long have you known the applicant? 2. What is your relationship to the applicant? 3. Please comment below (and on the other side if necessary) on why you think this person should be a member of the YouthNet YAB. Consider what unique qualities and talents this person can bring to the community. Reference's name ____________________________________________________ Signature of Reference ________________________________________________ Date _____________ Phone number of Reference ________________________ This REFERENCE FORM must be submitted by Monday October 1st, 2011 to: The CHS, MMS, or SOMS school library or: the Maplewood Public Library, 51 Baker Street, Maplewood, NJ 07040 or: the South Orange Public Library, 65 Scotland Road, South Orange, NJ 07079 For more information, please contact: Jane Folger at the Maplewood Library 762-1622 ext 5005 jfolger@maplewoodlibrary.org or Beth Halliday at the South Orange Library (973) 762-0230 bhalliday@sopl.org