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Connecticut Students for a Dream- New Haven Sign up Forms
✨ If you've landed on this page you have some interest in becoming a member of C4D and/ or working with us in our current campaigns HUSKY For Immigrants by attending our New Haven Team Meetings. ✨

Fill out this form to register for our New Haven Team Meetings: 

1.  💌 ✍️ Thursday, October 8th, 2026 
Time: 3:30pm- 6pm 

➡️ Location: 50 Orange St. New Haven, CT 

We are so excited to have you join! and to make CT a better place for immigrants! 😊

Thanks!

Español abajo👇

✨  Si has llegado a esta página, te interesa unirte a C4D o colaborar con nosotros asistiendo a nuestras Reuniones de Equipo en New Haven. ✨

Completa este formulario para inscribirte en nuestras Reuniones de Equipo en New Haven: 

1.   💌 ✍️ Jueves Octubre 8, 2026   
Hora: 3:30pm - 6pm 
 ➡️ Ubicacion -50 Orange st. New Haven, CT 

¡Estamos muy emocionados de que te unas! ¡y hacer de CT un lugar mejor para los inmigrantes! 😊

¡Gracias!
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Are you a C4D Member?  *
First Name/ Nombre *
Last Name/ Apellido  *
Pronouns/ Pronombres
Phone number/ Telefono  *
Email Address/ Correo Electronico  *
City/Ciudad *
Zip Code/ codigo postal 
Age/edad *
Do you have any dietary restrictions or allergies?
*
What Meetings are you registering for? / A Que Juntas te estas registrando?  *
What languages do you speak/understand?/ ¿Qué idiomas hablas/entiendes?
 *
What school do you go to? / ¿A qué escuela vas? *
Who invited you to this meeting?/ Quien te invito a esta reunion ?
 *
Parent/guardian Full Name/Nombre completo del padre/tutor
 *
Parent/Guardian Phone Number/ Numero completo del padre/tutor
 *
Parent/Guardian Email Address/Correo Electronico del padre/tutor
 *
Preferred language of parent/guardian
 *
Info about our campaigns!  Informacion sobre nuestras Campañas!
Below we have the campaign that we are working on! If you would like to receive specific information on the campaign note it in the question and we'll be sure to follow-up with you!

Abajo tenemos opciones sobre las Campañas que estamos dirigiendo aqui en CT. Si estas interesade en unas de las Campañas, indicalo en la pregunata abajo!

~~~~~~~~~~~~~~~
HUSKY for Immigrants: Statewide campaign that is fighting to open up the HUSKY health insurance program to immigrants here in CT.

Campaña estatal peleando por el derecho a aceder el program HUSKY que proporciona seguro medico para familias con estatus legal


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