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Membership 2023-2024
Member Information
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* Indicates required question
Email
*
Your email
Date
*
MM
/
DD
/
YYYY
Member Name
*
Your answer
Gender
*
Male
Female
Other
Race
*
Black or African American
American Indian or Alaskan Native
Asian
White
Native Hawaiian/Pacific Islander
Other Rade
More than one race
Ethnicity
*
Hispanic or Latino
Not Hispanic or Latino
Asian
White
Native Hawaiian/Pacific Islander
Other Rade
More than one race
Home Address (include city and zip code)
*
Your answer
Member phone
*
Your answer
Grade During 2023-2024 School Year
*
Your answer
Member School of Attendance
*
Choose
Cactus Middle School
Casa Grande Middle School
Mission Heights Prep
Union High School
Vista Grande High School
Villago Middle School
Home Schooled
Other
Please indicate your membership intentions:
*
I plan to be a member of my school alliance
I plan to be a member of the community-based alliance
I plan to be a member of both my school and the community-based alliance
I am interested in a leadership position
*
School Chapter
Community Chapter
Both
No thanks!
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