Queer and Trans Youth Council Application Please fill out the application below: Please fill out the application below to apply to be a member of the Queer and Trans Youth Council of Santa Cruz County (QTYC). QTYC members will also meet with the Santa Cruz County Office of Education Alliance for Youth Action. The Alliance is a multi-disciplinary alliance between various student leadership groups throughout Santa Cruz County to share ideas, learn new skills, and support one another's initiatives. We will meet as a collaborative bi-monthly to build community, leadership, and sustainable change. Step 1 of 3 33% Personal InformationNameFirstLastPreferred NamePronounsIdentities (gender, race/ethnicity, sexuality, etc)AddressStreet AddressCityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZIP CodeEmailCell PhoneHome PhonePreferred method of communication: Check all that applyTextCall Cell PhoneCall Home PhoneEmailSchool (If Applicable)Grade Level (If Applicable)I am involved with these community organizations: Check all that applyGSA, QSA, or SAGA, or Rainbow AllianceAssociated Student Body (ASB)Black Student UnionOther school clubAlliance for Youth ActionSport Team (volleyball, soccer, football, swimming, etc)Faith (I am involved in a youth group at my place of worship)Community Organization (I am involved with organizations like Food What?!, Girl Scouts, MAH, Brown Berets, etc)Availability QTYC members will need to commit to 8-16 hours per month for the 2021-2022 school year (September 2021 - May 2022). The time will be spent in meetings with the QTYC and with the Santa Cruz County Office of Education Alliance for Youth Action (4-10 hours per month) and meeting with their subcommittee and/or working independently on projects that the QTYC have chosen to pursue (3-6 hours per month). Our first meeting will be the first week of October. Future meetings will be scheduled based on councilmember availability. Tell us which day(s) and time(s) you are availableWill you need transportation? (Your answer will not affect your eligibility) NoYesNot sureWhat part of Santa Cruz County are you available for meetings?North CountyMid CountySouth CountyVirtual meetings onlySubcommittees!If you were to be a part of a subcommittee, check all that interest you.ArtsBookkeepingDanceDecorationFashion BallFundraisingGender Neutral BathroomsGeneral QTYC Intern/AdminHistory/ Queer EducationHistory/ Local & Oral HistoryMedia/PR/Social Media/Marketing/OutreachPFLAG (Parents, Family, Friends of LGBT)Queer Youth UpdatesSafe Schools ProjectSafe Schools/TrainingSportsSummitsTrans Teen ProjectTech Intern Essay or Video Submission Tell us a little about you -- Write a short essay (3-7 sentences to each question below) or create a 3-5 minute video answering the questions: What are your hobbies/passions/talents/expertise? (sports, religion, etc) What do you believe are the biggest issues your community needs to change? How do you define “youth empowerment” and what does youth leadership look like to you? What do you hope to gain from the QTYC? Describe a time you were a leader. What was challenging and what did you enjoy or learn? Free Range: Choose any one thing you would like to share. Upload Essay (word or PDF format)Link to video (such as Youtube or Vimeo) Letter of Recommendation Please provide a minimum of one letter of recommendation that speaks to your leadership abilities or potential. This letter can be from a teacher, employer, advisor, counselor, faith leader, coach, or other adult that has worked with you and can speak to your ability to keep time commitments, be self-motivated, and other leadership qualities or potential. Upload Essay (word or PDF format)Upload Essay (word or PDF format) Work (paid)Business NameGrade started9th10th11th12thYear(s) Involved1234Description of WorkBusiness NameGrade started9th10th11th12thYear(s) Involved1234Description of WorkBusiness NameGrade started9th10th11th12thYear(s) Involved1234Description of WorkBusiness NameGrade started9th10th11th12thYear(s) Involved1234Description of WorkVolunteer Work and Community Service (unpaid)Organization NameGrade started9th10th11th12thYear(s) Involved1234Description of Service or WorkOrganization NameGrade started9th10th11th12thYear(s) Involved1234Description of Service or WorkOrganization NameGrade started9th10th11th12thYear(s) Involved1234Description of Service or WorkOrganization NameGrade started9th10th11th12thYear(s) Involved1234Description of Service or WorkEXTRACURRICULAR ACTIVITIES Activity NameGrade started9th10th11th12thYear(s) Involved1234Description (Note any leadership positions.)Activity NameGrade started9th10th11th12thYear(s) Involved1234Description (Note any leadership positions.)Activity NameGrade started9th10th11th12thYear(s) Involved1234Description (Note any leadership positions.)Activity NameGrade started9th10th11th12thYear(s) Involved1234Description (Note any leadership positions.)High School Honors and Awards Honor/Award NameHonor/Award TypeDate Received (Mo/Yr)Description (Include nature and level of competition)Honor/Award NameHonor/Award TypeDate Received (Mo/Yr)Description (Include nature and level of competition)Honor/Award NameDate Received (Mo/Yr)Honor/Award TypeDescription (Include nature and level of competition)Honor/Award NameDate Received (Mo/Yr)Honor/Award TypeDescription (Include nature and level of competition) Certification I certify that I have considered each question carefully and that my statements are true and complete to the best of my knowledge. Furthermore, I understand that acceptance as a Youth Council Member may be denied or revoked if any information is found to be incomplete or inaccurate. IMPORTANT: Your electronic signature (please type your full name) is required below. Without your signature, your application is not complete. Digital SignatureUpon submission of your application, you should receive an email confirmation.