2018 Advocacy Institute PA Youth First Fellowship Application

The PA Youth First Fellowship Application is now closed.

Email Alison Marshall (amarshall@phmc.org) with any questions. Thank you!

Welcome to The Advocacy Institute PA YOUTH FIRST Fellowship application! Please complete this form to indicate your interest in the program. Someone will reach out to you with more details upon receiving this information. If you have any questions regarding this form or the program, please contact Amanda Irizarry (Advovacy Institute Program Manager) at 267.414.4371 or email her at airizarry@phmc.org.

To learn more about The Advocacy Institute and the incredible work of our youth, please visit our Facebook page www.facebook.com/AdvocacyInstitute/.

The Advocacy Institute PA Youth First's Youth Advisory Council (YAC) will collaborate with The Advocacy Institute to create a dynamic media campaign based on the knowledge acquired from the training. Through ongoing webinars and video conferences, the YAC will use their creativity and passion to frame the campaign in a way that speaks directly to their peers, is informative, and most importantly, inspires them to act. The campaign will reach teens and young adults throughout Pennsylvania and engage them in thoughtful discussion and prepare them for action against the opioid epidemic.

Participant Information

2. If you are currently attending school away from home (such as attending college in another city or attending a boarding school), please provide your HOME address:

Street Address (number and street name)
City
State
Zipcode

Parent/Caregiver Information *This question is required.

First Name

Last Name

Street Address

City

State

Zip

Home Phone

Cell Phone

Email Address This question requires a valid email address.

(Optional) Second Parent/Caregiver Information: