Social Emotional, Mental Health & Wellbeing Initiative Application
INVITATION TO PARTICIPATE

Committee/Action Teams/Focus Groups Needed

Please complete this form to indicate your interest in contributing to the Social Emotional /Mental Health and Wellbeing Initiative being launched by Northville Public Schools and Northville Youth Network in collaboration with our community partners.  To complete this application, please fill in all of the required boxes, and select 'submit'.  Please note that this initiative is in the development process, with several actions teams initiating work over the course of the next few months, while other actions teams may be formed over time as the work unfolds.
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Name *
Address *
City *
Phone Number *
E-Mail Address *
For NPS Parents: School(s) your child(ren) attend:
For NPS Staff: School(s) you work in
NPS Staff:  Please note your position.
For Northville Public Schools' Students, please note your current school:
For Northville Public Schools' Students, please note your current grade level
For Northville Community members, if you are affiliated with an organization, please identify below (if Health Organization is selected or your organization is not listed, select 'Other' and identify organization name):
In what capacity would you be interested in serving as part of this initiative? (please check all that you may be interested in; if interested in serving in more than a single capacity, you may additionally check 'Other') *
Required
What area(s) interest you most? (please check all that you may be interested in; if interested in additional areas beyond list, you may additionally select 'Other' and describe) *
Required
What background/experience do you have that may be helpful to this initiative? *
What has inspired and/or motivated you to join this initiative? *
What do you hope to accomplish as a member of this initiative? *
Thank you for your interest in contributing to the Northville Public Schools/Northville Community Social Emotional, Mental Health and Wellbeing initiative.
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