MOST Advisory Committee Application

Question Title

* 1. Contact Information

Name

Organization/ Company Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Organization type

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* 3. What is your ethnicity? (Please select all that apply.)

American Indian or Alaskan Native

Arab or Middle Eastern

Asian

Black or African American

Latinx or Hispanic

Native Hawaiian or Pacific Islander

White

Prefer not to answer

Other (please specify)

Question Title

* 4. Which of the following options most closely aligns with your gender?

Woman

Man

Non-binary/ Gender Fluid

Transgender

Prefer not to disclose

Other (please specify)

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* 5. What region of the state does your organization reside?

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* 6. Experience, Knowledge, Skills (Check all that apply)

Youth Leadership

Program Management

Grant Writing

OST Work Experience

Youth Mentor

Youth Development

Volunteer

K-12 Educator Experience

OST Program Planning/ Curriculum

Youth Development

Program Assessments

External Evaluations

Program Enrichment Activities

Professional Development

Education Research

Program Provider/ Contracted Vendor

Community Advocate

Parent Advocacy

Community Organizing

Finance

Other (please specify)

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* 7. Why are you interested in joining the MOST Advisory Committee? Explain your experience and any areas of expertise in the OST Sector.

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* 8. The following meeting schedule is preliminary. Additional meetings may be added as needed. All meetings will be in-person to provide for active participation. A stipend and mileage reimbursement will be provided as needed.

August 11, 2023
October 6, 2023
December 8, 2023
February 9, 2024
April 12, 2024
June 14, 2024
August 9, 2024

Please respond for the best Friday time frame availability option:

Friday mornings

Friday afternoons

Other (please specify)