School Assembly Application Form
This application is intended for High Schools and Middle Schools (8th grade only) who are looking for Youth Speaks to curate an assembly experience and conduct a writing/performance workshop.

Each 45-60 minute assembly is hosted by 3-4 trained Poet Mentors and ends with a student open mic. The form below exists to maximize our efforts and to create direct lines of communication to better understand your school’s needs.
Section 1- Assembly Info; Section 2 - Workshop Info; Section 3 - Budget Info

If you have any further questions or concerns, please don't hesitate to reach out to us at info@youthspeaks.org with the subject line “School Assembly.” If you are looking to book Youth Speaks in another capacity, outside of schools, please complete this form instead: https://tinyurl.com/YSBooking
School Name: *
Your answer
School Address, City, Zip Code: *
Your answer
Point of Contact on Assembly Day:
Name and role/position at the school
Your answer
Point of Contact Information:
Please provide both e-mail and phone number
Your answer
Please indicate a date that you can have us *
*Note: We can only offer school visits on Tuesdays, Thursdays, and Fridays for the 2019-2020 school year.
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Please indicate the time that you can have us *
Time
:
Please indicate an alternative day, date and time that you can have us
Ex: Tuesday, September 10th from 11 am - 12 pm
Your answer
What grade levels will be present at the assembly?
Please check all that apply
Please estimate how many students are expected to attend the assembly:
What tech equipment & materials will be available to us at the assembly? Please check all that apply.
Our assemblies are most impactful when we have at least 45 minutes dedicated to our work, aside from any announcements or other activities on behalf of the school. Can you provide that amount of time for our portion of the assembly?
Is this a themed assembly? If so, please elaborate:
Your answer
Please tell us anything else you think we should know about your school's population (student demographics, specific school setting, social climate, etc.)
Your answer
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