Membership Application

Kansas Youth Advisory Council

Serving as the voice of Kansas Youth in Care since 2000, the Kansas Youth Advisory Council is a statewide, youth-led council who provide positive recommendations and changes to the child welfare system.

Please complete the application form below. For any questions, contact kyac@dccca.org.

Eligibility Requirements

To be eligible to join KYAC, a youth/young adult has to have been or currently in foster care for any period of time on or after their 14th birthday. Eligibility ends upon the young adult’s 26th birthday.
Prospective members will begin a probationary period with certain requirements, such as attendance at two KYAC meetings and one RYAC meeting.
Once requirements have been met, our KYAC staff advisor will complete a new member evaluation.
If performance meets criteria, you’re officially a KYAC member!

Kansas Youth Advisory Council Membership Application

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Applicant Information

Name(Required)

Legal First Name Legal Last Name

Preferred Name or Nick Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Pronouns(Required)

Current Address(Required)

Current street address Current City State ZIP Code

Current Mailing Address (if different)

Cell Phone(Required)

Email(Required)

Do you have a Facebook profile?(Required)

How can KYAC best reach you?(Required)

Are you in foster care in the State of Kansas?(Required)

Are you currently receiving DCF Independent Living Services?(Required)

Additional Contacts

Please provide contact information for your Agency Case Manager or DCF IL Coordinator (if applicable)

Name

First Last

Agency and/or Region(Required)

Phone Number

Email Address

If you are no longer in DCF custody, please list a person that we can contact in case of emergency.

Name

First Last

Relationship

Phone

KYAC Membership Process

All prospective young adults must complete this application and sign the participation expectations agreement to be considered. Please send completed forms to KYAC@www.dccca.org. Approved applicants will be contacted by a KYAC staff advisor and asked toan interview with staff advisor(s) and KYAC co-chair(s).

Prospective members will begin a probationary period with certain requirements, such as attending two (2) KYAC meetings and one (1) RYAC meeting. Once requirements have been met, KYAC staff advisor(s) will complete a new member evaluation. The evaluation will be reviewed with the prospective member.

If performance meets criteria, you're officially a KYAC member!

Date you are available to start your probationary period(Required)

What activities do you participate in? (i.e., sports, school clubs/activities, outside of school lessons/practice, work?)(Required)

What availability do you have for KYAC meetings? (the council typically meets twice a month, but this can vary based on member availability(Required)

Which of the following are you interested in doing as part of KYAC? (Check all that apply)

Participating on a panel

Community Engagement

Helping organize virtual and in-person events

Creating newsletters/articles about KYAC & RYAC

Promoting and marketing KYAC and RYAC

Fundraising

Documenting events/meetings (note taking, writing summaries)

Graphic design for social media/events (flyers, banners, etc.)

Social media content

Helping organize and teach life and self-care, and other skills for RYAC

Recruitment

other ideas

Which of the following advocacy areas are you passionate about? (Check all that apply)

Youth engagement/involvement in court

Mental Health

Policy

System Change

Independent Living Skills and Benefits

Education

LGETQIA+ Issues

Rights of those in care

other

How did you hear about KYAC?(Required)

Examples: Referral form current/former KYAC member, event, social media, website, brochure/flyer, etc.

Why do you want to be a KYAC member?(Required)

What qualities do you think a KYAC member should posses??(Required)

What do you feel you need to be successful?(Required)

What issues relating to child welfare or foster care do you feel strongly about? Briefly describe.(Required)

Have you ever attended a RYAC event?(Required)

Do you require any accomodations?(Required)

Do you have any allergies or food restrictions?(Required)

KYAC Initial Participation Agreement

Untitled(Required)

understand that I am applying to become a member of the Kansas Youth Advisory Council (KYAC). By completing this application and participation agreement, I understand the following:

If l am selected to participate in KYAC, before becoming a member I must first complete a probationary period. During this time, I will be expected to attend x2 KYAC board meetings/events and help facilitate x1 RYAC class in their respective region. and demonstrate that I am an appropriate individual for KYAC.

Upon completion of this probationary period, the KYAC Advisors) and I will have an opportunity to review my performance during my probationary period to determine if I am an appropriate member for KYAC.

KVAC membership is not guaranteed following the probationary period. Membership will be determined by the KYAC Advisor(s), DCF Independent Living administration, and KYAC Co-Chairs.

The choices I make not only affect me but affect KYAC and the progress and success of the council.

My choices and behaviors at home, in the community, in school, in public, and on social media are a representation of myself, as well as KYAC. Any negative behavior may result in consequences, including temporary suspension, and possible permanent exclusion from KYAC. The consequence of the negative behavior will depend on the type and extent of the behavior and will be determined by the KYAC advisors), DC Independent Living administration, and program staff, depending on the circumstances.

My social media accounts are to be clean and appropriate. Content (including shared material) such as drugs, gangs, sexual content, illegal activities, bullying/fighting, etc. will not be tolerated.

If I am approved to become a member of KYAC there will be quarterly (3 month) evaluations to review my participation, attitude, behaviors, and social media accounts outside of KYAC meetings/events. KYAC advisor(s) will contact my workers) for additional praises/concerns before completing my evaluation (If applicable).

I understand I must commit to attending scheduled board meetings, RYAC events in my region, Summer Conference, Governors Conference, Strategic Planning, and any other events deemed necessary.

I will check and actively respond to the KYAC group chats, emails, phone calls, text messages, and any other forms of communication.

I understand that a background check is required if I am over the age of 18 prior to membership approval.