General Information:
 
Name
Last First Middle Initial
 
Address
Street Name/Number
City State Zip
 

Email
 
Phone #'s
Home Work Cell
 
SSN : Date of Birth: Age:
 
Sex:  
Male Female
 
 
Education:
 
School Location
Dates Attended Major/Degree
 
School Location
Dates Attended Major/Degree
 
School Location
Dates Attended Major/Degree
 

After reviewing the purposes of Tennessee Youth Advisory Council, please answer the following questions.
 
 
1. Please describe your experience while in foster care. For example: length of time in foster care, what type of foster placements you've lived in (group home, shelter, foster home, etc.), positive and negative experiences, and any other information related to your experience in care that you would like to share.
 
 
 
2. How can your experience in the foster care system help other youth who may be in similar situations?
 
 
 
3. What person so far has had the most positive impact on your life? In what ways has that person impacted your life?
 
 
 
4. What do you like about yourself and what assets or strengths can you bring to the council? For example: leadership skills, secretarial skills, fun, positive attitude, curiosity, motivation, etc.
 
 
 
5. If you had the power to change and improve one thing about foster care, what would you do? What would make foster care easier for you?
 
 
 
6. If you are no longer in foster care, what would you do to make it better or easier to transition out of foster care into living on your own?
 
 
 
References:
 
Please list 1 or 2 references. For example: your caseworker, foster parent, teacher, counselor, group home manager, boss, etc.
 
Name:
Relationship to you:
Address:
Phone:
Email:
 
 
Name:
Relationship to you:
Address:
Phone:
Email:
 
7. Why do you want to be on this Council?