Participation Form

Unidos Por Salud Youth Coalition

The Unidos youth coalition was established to ensure students have an opportunity to take the lead and create meaningful change in their communities in tobacco control efforts. Unidos coalition members will be provided with fun, innovative training on public speaking, working with elected officials, tobacco prevention, policy/advocacy work, leadership skills, data collection, and social norm change. By using these skills, members will be assisted in planning and organizing their own tobacco control efforts in their respective communities on the issues of flavored and mentholated tobacco products near schools and parks.

Qualifications

All youth members must be:

  • 13-18 years old
  • Be able to attend meetings as needed
  • Attend high school and have regular attendance
  • Able to work as a team

Responsibilities

Coalition Member’s responsibilities include:

  • Attend weekly meetings and events
  • Participate in trainings
  • Participate in at least 4 program activities annually
  • At least once a year present with staff or peers to local community organizations, city council members, city staff, or state legislators

Incentives to Participate

By participating, youth will receive:

  • Leadership training
  • Incentives during meetings including Unidos promotional gear and snacks
  • Meeting high school youth from across the Central Valley working on similar efforts
  • Opportunity to attend the Youth Leadership Summit at the end of the year
  • Opportunity to attend the annual Youth Quest trip to Sacramento
  • Letters of recommendation for university applications or employment
  • End-of-the-Year activities or incentives
  • Mentoring and coaching by Unidos staff

 How to Apply to the Unidos Por Salud Youth Coalition

Fill out the Youth Coalition form below. If you have any questions, please feel free to contact Community Engagement Coordinator:

Dulce Velazquez

Office: (559) 315-5542         

Cell: (559) 859-4250

E-mail: dvelazquez@healthcollaborative.org

 

Unidos Por Salud Participant Form

  • Student Information

  • Parent/Guardian Information

    I give permission for the student to participate in the Unidos Youth Coalition. I agree I will not hold the California Health Collaborative, Unidos Por Salud Project, California Department of Public Health, and/or my son/daughter’s High School, their employees, or agents responsible for any injury or sickness my child may incur during this program. I also confirm my decision listed above to allow/ not allow (circle one) my child to be transported by Unidos staff during the school year. I agree I will not hold the California Health Collaborative, Unidos Por Salud Project, California Department of Public Health, and/or my son/daughter’s High School, their employees, or agents responsible if I decide to allow them to transport my child for program activities or events.
  • This field is for validation purposes and should be left unchanged.