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DESERT SOUL MEDIA YOUTH SURVEY
This survey was created for Desert Soul Media Inc. an educational non-profit. We will not sell or distribute your information to any third parties. This data is collected to better provide services to our target audience. You can find more information at www.desertsoulmedia.org.
Email address *
Name *
Cell Phone
Text message is okay?
Clear selection
Parent or Caregiver Name *
Parent or Caregiver Contact Information (Cell) *
Which of the following interest you? (Mark all that apply)
Please provide a response to the question that corresponds to your interest.
Only answer for the interest you selected for above if you were not interested in anything listed please reply with your suggestions and we will offer common interest as options in the future.
What is your level of experience in Journalism
Clear selection
What is your level of experience in Performing Arts
Clear selection
What is your level of experience in Community Activism
Clear selection
What is your level of experience in Health and Wellness
Clear selection
What is your level of experience in Engineering and Technology
Clear selection
What is your level of experience in Entrepreneurship
Clear selection
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