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)