OREGON MILITARY TEEN PANEL APPLICATION
APPLICATION INSTRUCTIONS
1. Please complete and submit the application and short essay questions. Note: all documents must be typed.
2. Applications must request a recommendation from an Adult Leader (Principal, Teacher, School Counselor,
Director of community program applicant participates in, member of Military Leadership, etc.). The Adult
Leader cannot be a Family member of the applicant. Recommendation request information is included
in this packet to provide to the adult leader to complete.
3. The Child & Youth Coordinators will interview applicants to assess their ability to meet the general criteria,
leadership criteria and ORMTP responsibilities.
Completed paperwork listed above should be emailed to all of the following:
a. [email protected]
b. [email protected]
4. If you have any questions, please contact the following:
a. Hank Bauer – Lead, Child & Youth Program Coordinator 503-584-2346
b. Sarah Johnson – Child & Youth Program Coordinator 503-584-2390
c. Tori Shine – Youth Outreach Program Coordinator 503-584-2394
5. The deadline for all applications is 1 June 2017.
NEXT STEPS IN THE PROCESS
1. After the deadline you will be contacted by the Child & Youth Program staff to schedule a phone interview
between June 13 and June 21. The phone interview will be with the members of the Child & Youth
Program staff as well as selected volunteers.
2. The final selection of new ORMTP members will be made the first week of July and you will be notified by
email no later than July 8, 2017. The notification email will come from Hank Bauer, Lead, Child & Youth
Program Coordinator, [email protected] or [email protected].
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REQUEST FOR RECOMMENDATION
Dear ___________________________,
________________________________ (applicant’s name) is applying to be a part of the Oregon
Military Teen Panel. This leadership group allows military connected teens the opportunity to develop
effective strategies and implement solutions for issues they face as military connected youth.
Candidates are chosen through a thorough selection process and based on their experience,
leadership skills, dedication to, and willingness to speak on behalf of military children and
youth. Applicants must provide one recommendation from an adult who can speak to their character,
leadership skills and maturity, and they have asked you to provide this recommendation. This should
not take more than 10 minutes of your time and can be completed electronically. Please see the
instructions below for more details. Thank you for your support for our military youth and for helping
us find the best representatives for our state.
Instructions
 Please answer the recommendation questions on the following page to the best of your
knowledge.
 These questions can answered online at http://tiny.cc/ORMTP2018.
 If you would rather complete this form electronically, please save it and email it to
[email protected] or mail it to:
ORMTP Selection Committee
Child & Youth Program/SMFS
3225 State St.
Salem, OR 97301
More Information about the Oregon Military Teen Panel
Oregon Military Teen Panel members serve a two year term representing military connected youth
throughout Oregon. They help our program understand the current needs of military youth, help us
plan events, speak at community presentations, complete service-learning projects and help
promote our programs to other military families. At many of our events that are offered throughout
the year ORMTP members help facilitate activities for younger children as well as their peers.
Members participate in a conference call 1-2 times each month and meet for weekend planning
retreats approximately four times per year.
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RECOMMENDATION QUESTIONS
APPLICANT INFORMATION & QUESTIONS
Name:
How long have you known the applicant?
What is your affiliation with the applicant?
What are the applicant’s strengths?
What are the applicant’s weaknesses?
How would you describe the applicant’s abilities with the following functions:
Public Speaking/
Communication
Excellent
Good
OK
Not Good
Don’t Know
Leadership Skills
Excellent
Good
OK
Not Good
Don’t Know
Follow Through
Excellent
Good
On Commitments: ex. Projects/Homework
OK
Not Good
Don’t Know
Punctuality
Excellent
Good
OK
Not Good
Don’t Know
Creativity
Excellent
Good
OK
Not Good
Don’t Know
Other Comments:
RECOMMENDER CONTACT INFORMATION
Name/Title:
Phone:
Email Address:
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This form can be filled out and saved. When
saving the file, choose “save as…” and
save the document under a different name.
OREGON MILITARY TEEN PANEL APPLICATION
Complete all sections of the application. Incomplete applications will not be considered.
SECTION 1: APPLICANT INFORMATION
Applicant’s Full Legal Name: (First, Middle & Last Name)
Name you prefer to use:
Age:
Birthdate: (MM/DD/YYYY)
Gender:
___ Female
___ Male
Home Address:
City:
State:
Zip:
Applicant’s Email Address:
Applicant’s Phone Numbers (Include Area Code – XXX-XXX-XXXX)
Home:
Cell:
Year In School (Fall 2017):
___ 9th
___10th
___11th
___12th
Name of School:
Current GPA:
Graduation Year:
SECTION 2: PARENT OR LEGAL GUARDIAN INFORMATION
(ONLY ONE PARENT IS REQUIRED TO BE IN THE MILITARY)
Please complete the following information for
Parent 1
each parent/guardian
Parent 2
Parent Legal Name:
Name Parent Prefers:
Command (If Applicable):
Rank/Branch of Service:
Home Phone:
Cell Phone:
Work Phone:
Email Address:
SECTION 3: SIGNATURES
Applicant: I have prepared this application and certify that it accurately reflects my work:
Signature: _____________________________________ Date: _________________
Parents/Guardians: I fully support my teen’s application to the Oregon Military Teen Panel, and if
selected, understand the commitment and responsibilities my teen is expected to fulfill. I
understand I may be required to transport my teen to pick up locations.
Signature: _____________________________________ Date: _________________
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Applicant’s Name:
Applicant Essays
Using the space provided below, please briefly answer the following questions regarding your ability to
commit to the ORMTP and in representing Military Connected Youth statewide.
1. What youth-related programs/activities have you participated in?
2. What Military youth programs/activities have you participated in?
3. Why do you believe you are qualified to be the “voice” of Military Youth in Oregon?
4. If you could do three things to improve life for Military Youth in Oregon what would you do?
5. Please list three words that describe you.
6. Why do you want to become a member of the Oregon Military Teen Panel?
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