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Teen Stakeholder Advisory Committee Application

Nemours Children's Health is working to improve health equity in Delaware. We are looking for teens to help lead the new Research Expanding Access to Child Health (REACH) Center. We find it necessary to have the guidance and advice of teenagers, as they will usually know what works best for them and their communities. As a member of the Stakeholder Advisory Committee, you will have the opportunity to discuss and contribute to topics such as access to quality health, research that benefits your community, managing medical conditions, improving child health, and more. Selected teens will receive $50/hour and any transportation or other costs related to meetings will be covered. Please complete and submit the application below if you are interested in this opportunity. Thank you!

Name (First and Last):

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Email:

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Phone Number:

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Street Address:

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City:

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State:

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Zip Code:

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Parent/Guardian Name (First and Last):

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Parent/Guardian Email:

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Name of current high school:

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Select current year in high school:

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9th

10th

11th

12th

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Gender:

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Female

Male

Non-binary

Other

Prefer not to answer

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If selected "other" for gender, please specify:

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Race/Ethnicity (select all that apply):

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Hispanic or Latinx (any race)

Asian or Pacific Islander

Black or African American

Native American or other Indigenous group

White

Other

If selected "other" for race/ethnicity, please specify:

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What language(s) are spoken in your home on a regular basis? (select all that apply)

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English

Spanish

French

Creole

Other

If selected "other" for language, please specify:

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In at least 2-4 sentences, explain why equitable healthcare research is important to you and your community?

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If accepted, what is the best time(s) for you to attend committee meetings? (You may select more than one option)

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Mornings

Afternoons

Nights

Weekends

Do you have access to an internet connection and device for virtual meeting attendance?

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Yes

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Is there anything else you would like to let us know?

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How did you hear about us?

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