In Solidarity Application
What grade are you in? *
What is your full name? *
Your answer
What is your phone number? *
Your answer
What is your age? *
Your answer
What is your race?
Are you hispanic or Latinx?
If you are a student, what school do you attend?
Your answer
Tell us about yourself: what are your strengths? *
Your answer
Tell us why you want to participate in this conference: *
Your answer
What would you do with the information you learn at this conference? *
Your answer
List one reference that is not a family member, that we could contact to ask about your character (name and phone or email): *
Your answer
If you are selected, you and a parent or adult guardian would go to the conference in Atlanta, Georgia. Who is the adult that would attend the conference with you? Please list their name, your relationship, and phone or email contact. *
Your answer
If you are selected, the Safe Futures grant will pay for all of your expenses. Are you and your parent/adult guardian available to participate in all three days of the conference (May 9th, 10th, and 11th), and share what you learned when you get back? *
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This form was created inside of Whatcom Commission Against Domestic Violence. Report Abuse