2015-2016 CHILDHAVEN YOUTH BOARD APPLICATION APPLICANT INFORMATION:: Name__________________________________________________ Date of Birth __________________ Address _________________________________City___________________ Zip ___________________ Home/Cell Phone Number ________________________ E-mail ________________________________ School you will be attending in 2015-2016 __________________________________________________ Year in school in 2015-2016 (Freshman, Senior, etc.) _________________________________________ Are you able to commit to attending a minimum of 6 of the 8 Youth Board meetings? _____Yes _____No (If no, why not?) ______________________________________________________________ How did you hear about the Youth Board? _____At School _____On the Childhaven Website _____On the Childhaven Facebook Page _____From a Childhaven Board Member (List Name) __________________________________________ _____From a Childhaven Youth Board Member (List Name) ____________________________________ _____From a Childhaven Staff Member (List Name) ___________________________________________ _____Other (Please List) _________________________________________________________________ PARENT/GUARDIAN INFORMATION:; Name 1_________________________________________________Relationship ___________________ Address _________________________________City___________________ State _____Zip _________ Home/Cell Phone Number ________________________ E-mail ________________________________ Name 2 _________________________________________________Relationship __________________ Address _________________________________City___________________ State _____Zip _________ Home/Cell Phone Number ________________________ E-mail ________________________________ ESSAY QUESTIONS:; On a separate piece of paper, please answer all of the following questions: 1. Why are you interested in serving on the Childhaven Youth Board? 2. What skills will you bring to the Youth Board? 3. What are your goals as a Youth Board member (what do you hope to accomplish)? 4. Do you have any previous experience as a volunteer or fundraiser? REFERENCES:; Please provide 2 letters of recommendation. These letters should be written by someone other than a relative or friend and should address why you would be a good addition to the Childhaven Youth Board. Letters must be given to the applicant in a sealed and signed envelope. The applicant should mail both letters along with the application to Childhaven. DEADLINE:; Applications and letters of reference must be received by Childhaven by April 30, 2015 at 5 pm. It is the responsibility of the applicant to make sure all materials have been received by the deadline. SIGNATURE:; I certify that the above information is true and is submitted voluntarily. This information may be used and disclosed for Childhaven purposes and I realize that as a Childhaven volunteer, I will not be paid for my services. Signature _________________________________________________________Date________________ Parent Signature ___________________________________________________ Date_______________ E-MAIL/MAILING ADDRESS:; Please return your application with essay and letters of recommendation to Childhaven| Attention: Program Operations Manager / Youth Board Application | 316 Broadway | Seattle, WA 98122 SELECTION TIMELINE:; April 30, 2015 – Application and letters of reference received by Childhaven May 6, 2015 – Candidates notified via e-mail that application has been received May 22, 2015 – Selection Committee reviews applications June 1, 2015 – New Youth Board members are notified by mail June 19, 2015 – Candidate Acceptance Letters received by Childhaven August 13, 2015 – Mandatory Youth Board Retreat (9 am – 2 pm)
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