Youth Ambassador Interest Form

Become a Youth Ambassador! 

Did you know? 

Missouri is ranked #15 in the United States for school shootings? Or, that Missouri is ranked #28 in the United States for deaths by suicide with adolescents between the ages 15-19? Alive and Well Communities want to hear from YOU all about how to improve your safety, health, and well-being at school. 

Why Alive & Well Communities? 

Just like our name, our mission is to heal our communities and reach zero health disparities statewide. Alive & Well Communities also believe lifting youth voice is critical for systemic change. We do this by engaging in conversations and learning that enables us to build a common understanding about how trauma impacts our community. 

What do I get out of this? 

We get it! This topic is heavy and is triggering. That is why we want you! With so much going on in our schools, we need to hear from you. THE REAL & RAW! The youth ambassador program is designed to create a culture of success, safety and trust for students and families to thrive inside and outside of the learning space. Complimentary programming for families is available for those who wish to participate. 

Benefits of becoming a youth ambassador: 

  • Leadership skills
  • Connection with peers 
  • Explore your strengths
  • Build connection with your community 
  • Community service credit and a personalized recommendation letter 
  • $500 Stipend

Update 11/27/23: Registration for St. Louis program is now closed. 

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Student First Name *
Student Last Name *
Student Pronouns *
Region *
Student E-mail Address *
Student Phone Number *
Grade *
Student Age *
Student School *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian E-mail Address *
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