Teen Board and Ambassador Returning Participant Applications

Full Name*

First Last

Grade in school (2022-2023)*

Please enter a number from 9 to 12.

School you attend*

Home address*

Street address City State ZIP

CellPhone

Home phone

Personal email address*

Parent's or guardian's name*

First Last

Parent's or guardian's email address*

Please indicate your availability to meet for Teen Board or Ambassador meetings:*

(Check all that apply)

Wednesdays, 4:30 to 6 p.m.
Wednesdays, 6 to 7:30 p.m.
Thursdays, 4 to 6 p.m.
Thursdays, 6 to 7:30 p.m.

List your extracurricular activities:

I’m applying for:*

Teen Ambassadors
Teen Ambassadors are a group of Louisville and Southern Indiana students in 9th through 12th grade. This group meets every other month, just five times during the school year. Teen Ambassadors support Teen Board initiatives, volunteer at Norton Children’s Hospital Foundation events and fundraise. This group is a great stepping stone for those interested in the Teen Board and other Norton Children’s Hospital involvement.
Teen Board
To apply to be on the Teen Board, you must be a junior or senior in high school, or have previously participated in Teen Ambassadors. This group meets once a month to plan initiatives and discuss foundation events to improve fundraising and community outreach in Greater Louisville. Teen Board members are expected to volunteer at Norton Children’s Hospital Foundation events and raise funds for Norton Children’s Hospital.

1. How many years have you participated with Teen Ambassadors or Teen Board? Why would you like to be a part of this group again? Please explain in detail.

2. What is one thing you would change about Teen Ambassadors or Teen Board?

3. If you have been on the Teen Board, what is one thing you feel you need to improve to be a more active member of the board, something you have struggled to do in previous years? Please explain in detail.

4. What experience or skills do you expect to gain or continue to grow from being a member of Teen Ambassadors or Teen Board?

5. How do you envision the groups growing this year? How do you hope to facilitate that growth? Please explain in detail.

6. Does your parent or guardian want to receive Norton Children’s Hospital Foundation email updates?

Yes
No

7.Do you have suggestions for a presenting sponsor for the 2022–2023 Teen Ambassadors and Teen Board? (This typically is an individual or organization in our local community.)

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As we continue to seek to protect our patients, face masks are required in patient settings such as hospitals, doctors’ offices and medical centers.

Teen Board and Ambassador Returning Participant Applications