There are so many things in life that are decided for you by the adults in your lives. It’s
time you had a chance to be heard…especially when it comes to issues of
sexuality. Join the REVolution and be heard!
REV (short for REVolution) is Planned Parenthood of Southwestern Oregon’s Youth
Action Council- a group of dynamic and fun people age 14-19 that work together to
improve the sexual health of their communities through education and advocacy.
REV members do a range of things, including:
• Train nursing students on how to best meet the sexual health needs of
adolescent patients as a part of PPSO’s Adolescent Health Care
Communication Project.
• Plan and organize fun educational opportunities for their peers.
• Create new fun and innovative projects to advocate for youth and educate
young people and adults on the importance of sexual health.
REV members commit a minimum of 8 and up to 20 hours per month to trainings,
meetings, planning, and events. REV members must attend all trainings, meetings,
and events.
Are you interested? If this sounds like a group that you would like to be a part of or
learn more about, please fill out the attached application ASAP. Applications will be
accepted on a rolling basis until the group has been filled.
Drop off at or mail it to:
Planned Parenthood of Southwestern Oregon
(PPSO)
Attn: REVolution
125 S. Central Avenue
Medford, OR 97501
Or email it to:
Elissa.Denton@ppsworegon.org
Or fax to:
(541) 773-1634
If you have any other questions please don’t hesitate to call Elissa at (541) 770-3331
ext. 5017 OR e-mail Elissa.Denton@ppsworegon.org.
REVolution Application
Applications will be accepted on a rolling basis until the group is filled. Please fill out
application completely. All applicants will be informed that their application was received.
Name:
Address:
City:
Home Phone:
Zip:
Cell Phone:
E-mail address:
School (if attending):
Texting OK? Yes
No
Age:
Parent/Guardian name and email: ______________________________________________________
1. Why are you interested in joining REV, PPSO’s Youth Action Council, and what do you hope to
contribute to the group?
2. We’d like to learn more about you! Tell us a little more about who you are or what you are
passionate about—write a paragraph OR write a short poem OR write a song/rap OR submit
artwork about yourself.
3. What do you think the biggest issues/challenges are in your community? The biggest
strengths/successes?
Planned Parenthood of Southwestern Oregon
REVolution Application
4. REV is a commitment- we expect you to participate a minimum of 8 hours/month (more when
we are preparing for an event) and attend ALL REV meetings. What other activities (work,
sports, music, clubs etc.) will you be involved in and what is your plan for balancing your
schoolwork, REV, and other activities?
5. Tell us about experiences you have working with a group of your peers OR tell us about a time
you helped a friend or peer with a question or problem.
6. Is there anything else you want us to know about you?
7. Personal Reference: Please provide the name and contact information of a reference from an
educational setting. A teacher, school counselor, coach, administrator or an adult you know
from any other activity would be great! (This should not be a parent, guardian or family friend.)
Planned Parenthood of Southwestern Oregon
REVolution Application
I understand that as a part of Planned Parenthood of Southwestern Oregon’s REV
group, I will be asked to:
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Attend all trainings and meetings
Respect diverse opinions
Work toward building a community that supports the sexual health and safety
of all youth.
Represent myself and the organization responsibly
Work as a part of this council from August 2013 through June 2014.
Seek parental permission in order to participate in any PPSO activities that
occur during the school day.
By signing this application, I promise that all of the above information is true.
Student Signature
Date:__________
Parent(s)/Guardian(s)
Name: __________________________________________________
Email: ___________________________________________________
Phone:___________________________________________________
Name: __________________________________________________
Email: ___________________________________________________
Phone:___________________________________________________
If under 18 parents will be asked to attend an orientation meeting (Date TBA).
Parent/Guardian Signature
Planned Parenthood of Southwestern Oregon
Date:__________