Legacy Community Health Teen Health Ambassador Application

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Thank you for your interest in the Legacy Community Health Teen Health Ambassador (THA) program 2024! The program was created to provide teens (ages 13-18) with a meaningful, flexible and fun way to get more involved in your own health and health care – and to help other teens and community members do the same. Our goal is to help you gain valuable skills and experience, make some new friends and future career connections, and be part of creating healthy change for teens in our community!

Each applicant must provide the following information and submit the application. The application should take 20-25 minutes to complete. Acceptance notifications are sent out by the last day of the month in which you applied.

Information will only be used to contact applicants about the THA program.

First Name

Last Name

Preferred email

Preferred telephone

Address

Street

Street Address Line 2 (apartment/unit number)

State

Zip code

What grade are you in this school year (2023-2024)

Which school do you attend? (please include full name of school)

School name

City

State

Zip code

Why do you want to be a Teen Health Ambassador? (please provide 3-5 sentences):

Check all the activities that you are interested in:

Take part in online surveys and focus groups to provide feedback on health care services, topics for website content, ad campaigns, and more.

Volunteer at events like fun runs, fitness challenges, health fairs, and donation drives (for example, event planning, stuffing “swag” bags with materials, event set-up and clean-up, helping to staff events).

Participate in educational videos and photo shoots.

Conduct research on various health and wellness topics and write summaries.

Write short articles and blog posts to be shared on the Legacy Community Health Teen Well page (legacycommunityhealth.org/teenwell/) and blog.

Lead health activities at your school or club.

What size t-shirt do you wear? (Adult unisex sizes)

Submit

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