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Please note: Applications are due January 31, 2025.
Young Adult Advisory Council Application
First Name
(Required)
Last Name
(Required)
Email
(Required)
Address (Street #, street, city, state, ZIP)
(Required)
Phone
(Required)
Age
(Required)
Birthdate
(Required)
Are you in school?
(Required)
Yes
No
Name of school
If you are pursuing a degree, what is your major?
Are you living with an autoimmune disease or are you a caregiver?
(Required)
I am living with an autoimmune disease
I am a caregiver
Neither, but I am interested in autoimmune disease
If applicable, which autoimmune disease(s) are you living with?
Tell us a little about yourself.
(Required)
Why do you want to join the Autoimmune Association's Young Adult Advisory Council?
(Required)
Are you able to commit to this volunteer position for one year, including attending a virtual meeting for approximately one hour every quarter and communicating throughout the year as needed?
(Required)
Yes
No
Maybe
Is there anything else you'd like to add?
CAPTCHA
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