2021-2022 SPTS Youth Council Returning Member Application Form
The SPTS Youth Council is open to high school students in Monmouth and Ocean County, who are interested in learning more about mental health and wellness, stress management, resiliency, and how to help peers in need. Since 2015, over 400 high school students have participated in the Youth Council. Students will participate in monthly meetings that focus on the components of the Wellness Wheel – emotional, intellectual, physical, social, environmental, financial, and spiritual wellness. Students will also learn about their role in suicide prevention, the importance of going to a trusted adult when they need help, and local and national resources.

If you are interested in joining the SPTS Youth Council, please complete the following member form. If you are a new member applying for the first time, you will be asked to submit a reference letter on your behalf. This letter can be submitted after your application online at www.sptsusa.org/youthcouncil. Returning applicants are not required to submit a reference letter.

After you submit your form and reference letter, the Youth Council manager will contact you to provide more information on our first meeting. If you have any questions, please contact SPTS Operations Manager, Kyle Kalbach, at kyle@sptsusa.org.
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Member Information
In this section you will fill in your basic contact information.
Name (First, Last) *
I am applying for *
Home County *
Grade level as of September 2020 *
Age *
Home Address (Street, City, State, Zip) *
Home Phone Number *
Cell Phone Number *
Email Address *
Do you have a Driver's License? *
Will you be receiving a Driver's License this year? If yes, please write the date in "Other". *
Will you be driving yourself to meetings? *
Parent/Guardian Information
Please fill-out the following section regarding your parents/guardians information. There are two sections available for parent/guardian information.
(1) Parent/Guardian Name (First, Last) *
Address (Street, City, State, Zip Code) *
Home Phone Number *
Cell Phone Number *
Email Address *
(2) Parent/Guardian Name (First, Last)
Address (If different from Parent/Guardian 1)
Home Phone Number (If different that Parent/Guardian 1)
Cell Phone Number
Email Address
School Information
In this section you will be asked to provide contact information for you school including address and phone number. You will also be asked to provide the name and email addresses of your Guidance Counselor and SAC (if applicable).
School Name *
School Address (Street, City, State, Zip Code) *
Guidance Counselor Name *
Guidance Counselor Email *
Student Assistance Counselor (SAC) Name (If Applicable)
SAC Email (if applicable)
School Phone Number *
School Website (if any)
Youth Council Questionnaire
Please answer the following questions honestly.
Can you commit to being a member of the 2021-2022 SPTS Youth Council? *
Describe a trusted adult who is important to you. What makes them a trusted adult to you? *
How did you hear about the Youth Council? *
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