Request edit access
Akoma Rites of Passage            Prince/Princess Application            
Akoma Rites of Passage Program is a journey for young girls and boys, 9 to 16 years of age. The journey embraces the teachings for self-awareness and self-respect. The journey is approximately a three-month cycle, coupled with a mentor. The mentoring affords the young girl/boy the opportunity to have some  guidance from an outside individual who has her/his best interest at heart. The mentor can assist with the navigation of life, ideas and dreams. All mentors are required to have child abuse clearances.

The teachings will be from an Afrocentric perspective. They will be held weekly with a variety of topics, such as, but not limited to journaling, healthy living and relationships. The culmination of the Rites of Passage program will be a cultural trip.

The sessions will be held on selected Saturdays, 9:00am - 12:30pm.

We look forward to having you join us!
Sign in to Google to save your progress. Learn more
Email *
Name of Child *
Prefer to be called/Nickname
Date of Birth *
mm/dd/yyyy
MM
/
DD
/
YYYY
Current Address *
Please include: Street address, City, State & Zip
Permanent Address
If different than current address. Please include Street address, City, State & Zip
Home Phone number
Example: 2155555555
Cell Phone number
Example: 2155555555
Hobbies/Interests of Child
T-Shirt size *
Child's Email:
Parent's/Guardian's Name(s) *
Parent's/Guardian's Email: *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms