Youth Leader Application for Video, Book & Poster Project about HIV

Contact Information
Name First Nation Community City, BC Postal Code Home Phone Work Phone E-Mail Address

What Kind of Leader Are You?

Please click all that applies: ___ Cultural ___ Education ___ Political ___ Arts ___ Social ___ Other, Specify

About the Project

We are looking for Youth Role Models that are willing to be in our coffee table book and poster featuring Youth Leaders thoughts on HIV and a video which we will put on our YouTube page and CDR. The material will be sent out to all the bands in the North West, Northern Interior and North East. We will want you to comment about HIV. Dont worry if you dont know enough about HIV, if your application is successful we will provide a short training session on it and answer any questions.

How Do You Feel About Being a Role Model for Youth?

How do you keep living a healthy lifestyle? Who or what inspires you? What drives you to make a difference? What is the secret to your success? Minimum six complete sentences.

Send to:

Colette Plasway, Program Coordinator Northern BC First Nations HIV/AIDS Coalition 987 Fourth Avenue, Prince George, BC V2L 3H7 Email: Colette@csfs.org, Toll Free: 1-800-889-6855, Fax: (250) 562-2272