Community Council Youth / Family Facilitator Application

Please complete this form and upload your resume.

Applicant Name*

Contract you are applying for :*

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Do you have lived experience of Philadelphia’s youth serving systems?*

Do you have lived experience of Philadelphia’s youth serving systems (e.g., behavioral health, child welfare, juvenile justice) as either a youth or a primary caregiver of youth?

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Please describe your lived experience ( if selected YES)

Contact Phone*

Email Address*

Preferred Method of contact

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Why are you interested in bringing together the voices of local leaders in the community to support youth/family behavioral health?*

Only for Lead Facilitator applicants to complete - Q1. Please describe your existing work within the community for families or youth.

Only for Lead Facilitator applicants to complete - Q2. Please describe your experience coaching or mentoring other colleagues around a specific role or purpose.

Only for Lead Facilitator applicants to complete - Q3. Please describe your ability to schedule your time, organize materials, and manage multiple priority meeting.

Date of Application

File Attachments*

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