4976 Eichelberger Street, St. Louis, MO 63109

(314) 482-5973

Youth Effectively Transitioning to Independence (YETI)

March 23-25, 2018in Portland, OR

Deadline:January 30, 2018

GHA is a not-for-profit, community-based organization, dedicated to the advocacy, education and support of families affected by bleeding disorders. We have been serving families since 1969 in southern Illinois and eastern Missouri.

GHA is looking for a prominent leader that will be willing to contribute to the design and creation of teen programs in the future. The teen must live within the GHA service area, be ages 14-20 years old, and able to attend the YETI conference March 23-25. YETI will be held atCamp Collins, 3001 SE Oxbow Pkwy, Gresham, OR 97080.

Hemophilia Foundation of Oregon (HFO) created the YETI conference to help bleeding disorder organizations work to transition teens from living in their parents’ home to successfully living a life on their own after high school. This experiential weekend,facilitated by GutMonkey,is to learn about teens with bleeding disorders transitioning to adulthood.

GHA will cover the teens airfare to and from YETI. HFO will cover all other costs associated with YETI, food and lodging. Teens must arrive in Portland by4 p.m.on the 23th and cannot depart from Portland until after1 p.m.on the 25th. There is a Free shuttle provided from the airport to camp and back to the airport. The teen will travel with either a staff member or volunteer from GHA roundtrip, no one under 18 should be flying alone to and from YETI.

Those attending from GHA:

  • one adult who is representing GHA (Jennifer McNamee)
  • one staff member from the local HTC (Makenzie Sledd)
  • one teen (ages 14 - 20) (TBD)

Eligibility:

Members must be diagnosed with a bleeding disorder and live in GHA’s service area.

  • Participant must be able to travel independently without chaperones.
  • Mandatory travel dates include March 7 - 9, 2018
  • Participant must be able to self-administer any medications
  • Participant must be able to pay for some meals, travel to and from Washington D.C., other entertainment or tourist expenses incurred.NHF does provide several meals.

Application Deadline:Applications must be received by January 30, to

Please answer all questions(it is necessary to ensure proper registration). Submit this application by January 30, 2018. Recipients will be determined through aselection process conducted by a volunteer review team and willbe notified no later than January 31, 2018.

Name Last ______First ______

Mailing Address______City______State ______Zip Code______

Date of Birth: Month _____ Day ___ Year____ Gender Female ______Male ______

Parent’s Name ______

Parent’s Email ______Teen’s Email ______

Parent’s Phone (_____) ______Teen’s Cell Phone (_____) ______

Special Dietary Needs: ______

Describe your bleeding disorder

 Hemophilia A  Hemophilia B VWD

 Other Bleeding Disorder  Platelet Disorder

Provide the name of your hematologist or hemophilia treatment center. ______

Describe your reason forwanting to attend YETI. ______

______

______

How will you take the information back to your community? (e.g., volunteering)

______

Grant recipients must agree to provide feedback regarding their experience at YETI.

Signature of Applicant______Date ______

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