Program Registration Form

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Today's Date *

YYYY

What program is this for? *

Girl World: A leadership development program for girls, femmes and non-binary/gender expansive youth of color. Program activities support participants as they cultivate self-esteem and self-advocacy, learn the power of teamwork, research, and promote awareness of social justice issues, particularly those affecting them. Through these activities, Girl World participants develop leadership skills, explore their college and career options, and learn about the importance of positive decisions and healthy relationships.

Just Us: Grounded in restorative justice principles and provides a space for middle school youth build community, increase social justice awareness as they discuss history and current events, and support each other in dealing with the challenges they face.

Full Circle: Brings young people who have been impacted by unjust systems to a grounded experience and understanding of Restorative Justice. By the end of this training, participants will have developed skills to identify and assess individual and group needs, coupled with Restorative Justice skill-building practices.

The Peace Ambassadors Program: A paid apprenticeship for young adults (17-24 years old) who have faced homelessness or are system involved. Participants learn to become professional Restorative Justice practitioners. This apprenticeship is designed to be one of the most intensive RJ trainings available in the city, with over 400 hours of training coupled with weekly real world practice facilitating programming in communities and schools.

Other:

First Name *

Last Name *

Birthday *

YYYY

Address *

Zipcode *

Neighborhood *

Gender Identity *

Male

Female

Transgender

Gender-neutral

Non-binary

Other:

What Pronouns do you use? (He/Him, She/Her, They/Them) *

Grade Level *

What school do you attend? *

What is your email? *

Race (check all that apply *

American Indian or Alaskan Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other:

Required

Ethnic Origin (check all that apply) *

Mexican, Mexican American, Chicano

Another Hispanic, Latino, or Spanish Origin

Not Spanish/Hispanic/Latino

Puerto Rican

Central American

Cuban

Prefer not to disclose

Other:

Required

Do you Identify with any Religious Affiliations? *

Yes

If "Yes," please specify your religion

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