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SBHA YAC
MAP
BE THE CHANGE
EVENTS
MEDIA CONTENT
Teens and Vaccines Podcast
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SBHA Youth Advisory Council Application 2025
REQUESTS
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SBHA YAC
MAP
BE THE CHANGE
EVENTS
MEDIA CONTENT
Teens and Vaccines Podcast
OPPORTUNITIES
SBHA Youth Advisory Council Application 2025
REQUESTS
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Your Profile
Map Request
Post an Event
Media Content
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Your Profile
Map Request
Post an Event
Media Content
Post a Job
Contact Us
Map Request
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Organization Name
(Required)
Organization Level
(Required)
National
State
Local
Are you a school-based health center or affiliated with one?
(Required)
Yes
No
Organization Website
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Organization's Youth Development Social Media (if available)
Organization's Youth Development Social Media (if available)
Organization's Youth Development Social Media (if available)
Main Contact Name (for youth development work)
(Required)
Main Contact Email (for youth development work)
(Required)
Main Contact Phone (for youth development work)
Opt Out
Please check this box if you prefer the main contact information to remain private and not shared publicly with other youth development organizations
What youth development opportunities are available?
(Required)
Youth Advisory Council
Youth representation on school health committee and/or health center advisory board
Provide feedback on health center services and experience
Peer education, mentoring, counseling, or support groups
Health career pathway/student shadowing/ health center aide
Advocacy activities (local, state, or national)
None
Other
Other opportunities
What age group(s) does your youth advisory council serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) does your youth representation on committee or board serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) do you solicit feedback on health center/organization from? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) does your peer education, mentoring, counseling or support groups serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) does your internships, career pathway, student shadowing, or health center aide serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) does your advocacy activities serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
What age group(s) does your other youth development opportunities serve? (select all)
(Required)
Elementary School
Middle School
High School
College/recent graduate
How many youth on average participate in your youth advisory council?
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average participate in your other opportunity?
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average participate in your advocacy activities
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average participate in your internships, career pathway, student shadowing, or health center aide opportunity?
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average participate in your peer education, mentoring, counseling, or support groups?
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average provide feedback on health center/organization services and experiences?
(Required)
1-5
6-10
11-15
16-20
More than 20
How many youth on average are represented on your committee or board?
(Required)
1-5
6-10
11-15
16-20
More than 20
How frequently does your youth advisory council meet or occur?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently does your other opportunity meet or occur?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently does your advocacy activities meet or occur?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently does your peer education, mentoring, counseling, or support groups meet or occur?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently are your internships, career pathways, student shadowing, or health center aide opportunities available?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently do you solicit feedback on health center/organization services and experiences?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
How frequently does your youth representation on committee or board meet or occur?
(Required)
Daily
Weekly
Bi-weekly
Monthly
Quarterly
Annually
Other
Other
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What would you like to get out of this network?
Insight into what other youth development work is happening around the country
Connecting with other youth/councils
Connecting with other youth serving organizations
Contact information for other councils
Youth development training
This field is hidden when viewing the form
How often would you like to receive communication from us?
Weekly
Bi-weekly
Monthly
Quarterly
This field is hidden when viewing the form
Through which platform would you like to receive communication from us? (Select all)
Email
Texts
Social Media
Online platform (i.e. Basecamp, Slack, Facebook group...)
network
Please check this box if you would like to connect with this future network
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