CII is launching a new program focused on building relationships between current and former system-involved youth (ages 14-27), mentors and peers. This new program is intended to support your educational success, identify meaningful career opportunities, support your emotional and physical wellness and help you develop a network of support for navigating life's journey. Fill out the form below to sign up for more information about the program!

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* 1. What is your full name? Please include your first and last name.

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* 2. Please provide the following information.

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* 3. Are you interested in joining the "Youth Commission"?

The "Youth Commission" is a group that will help develop the new youth program. Your role as a member of this group is an important one - your involvement will help create the program from the ground-up, so that it is most beneficial to you and your peers. Plus, you will be compensated for your time and participation.

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* 4. What types of activities and services are you most interested in?

Please check all that apply to you and use the box below to specify the activities you enjoy.

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* 5. Do you have any additional comments or suggestions for us to consider?
(Optional)

Thank you for your time in filling out this survey.

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