Please complete the below form as completely and accuratly as possible for consideration. If you have any additional questions, please contact us here.

First Name
Last Name
Address
City
State
Zip Code
Telephone
Cell Phone:
E-Mail
Grade you are in:
Your School:
Name of Parent/Guardian:
Emergency Contact:
Relationship:
Emergency Contact Information (Address, Phone and E-Mail)
What are some of your Hobbies and Interests?
Are you able to meet once a month on the weekday's after school to discuss ideas and participate in TeenVillage activities?
Why do you want to be a member of the Teen Advisory Group (TAG)?
What skills or experience would you bring to TAG?
TAG is a resource group for teenvillage.org in areas such as activity planning, advertising and promotion. How do you think your skills could be best used? Do you have any special skills or talents such as Graphic Design?
 
The following two questions refer to the website review of www.teenvillage.org.
What do you like most about the website?
What do you like least about the website?
What suggestions would you make to improve the website?
Are there any topics that you would like to see covered in the website?