Ampersand Families Website | Contact Us

MYVoice New Youth Form

Joining MYVoice activities for the first time? Please fill out this form with some basic info about yourself.

Name & Birthdate
Are you a Minnesota young person between the ages of 12 and 22, who has been in foster care or adopted?*
First Name*
Last Name*
Preferred Name
Birthdate* Calendar
Contact Information
Please note that by giving us your email address, we will be adding you to our youth-specific email newsletter. We send out 1-2 emails per month. You can unsubscribe to this list at any time.

For your phone number, we often text announcements about MYVoice activities. Please include your phone number if you're ok with us using it to text, call, or leave messages for you about MYVoice activities.
Youth Email
Cell Phone Number
Enter Int'l Number
Home Phone Number
Enter Int'l Number
We need your address for our records. Also, sometimes we need to mail you things for participating in MYVoice activities.
Current Location Type*  
Current Location Street Address*
Bldg./Apt. #
Current Location City*
Current Location State*
Enter Region
Current Location Zip Code*
Date Youth Arrived at Current Location* Calendar
What race/ethnicity do you identify as? Check all that apply. If you race/ethnicity is not listed, please select other and type in your race/ethnicity in the "Race/Ethnicity Other" field.
Race/Ethnicity (please select all that apply)
Race/Ethnicity Other (If other, please type in race/ethnicity)* *
Race/Ethnicity Notes
Sexual Orientation
If you are willing to share it, what is your sexual orientation?
Sexual Orientation  
Sexual Orientation Other (If other, please type in other sexual orientation/s)* *
Sexual Orientation Notes
Gender Identity
If you are willing to share it, what is your gender identity?
Gender Other, (If other, please type in other gender/s)* *
Gender Notes
Please select the pronouns you want us to us when referring to you. If you have questions about pronouns, you can copy and paste this link into a new webpage tab to learn more:
Pronouns Youth Uses
Pronouns Other (If other or multiple pronouns, please type in desired pronouns)* *
Pronoun Notes
How Did You Hear About MYVoice?
How did you hear about MYVoice?
(If Other, please type in name)* *
Adult/Emergency Contact
If you are under 18, we need an adult we can contact, if needed. Please provide contact info for an adult we can contact about you?
Are You Under Age 18?*
Adult First & Last Name* *
Adult Contact Phone Number*
*Enter Int'l Number
Adult Email Address
Who is this person to you?*
Other Relationship* *
Anything Else You'd Like Us to Know
Is there anything else you'd like us to know about you right now? Like special considerations or interests you have? We look forward to having *your voice* as a part of MYVoice!
Extra Information
By clicking the Save/Submit button below you agree to InReach Solutions' Terms of Service and Privacy Policy