Open Your Eyes - Program Registration
Open Your Eyes is a program created by Northern Lights Youth Services to highlight issues that occur in a variety of communities the organization serves. The eyeball symbol is used by groups to tie to an issue such as opiod use, distracted driving, bullying, etc.

In order to participate in this program, please fill out this quick survey so that Northern Lights Youth Services can track progress and use this research to advance the organization's future funding opportunities. Your first and last name nor E-mail address WILL NOT be given out. If you are doing this program with your chapter/with a group, only have one individual submit the program registration - they will act as the primary contact.

Thank you!

State
City
Your answer
School
Your answer
How many members are in your group/chapter?
Your answer
What is the time frame of the program? (i.e. planning process to final event will take place from January to March)
Your answer
What is the population of the community this program will take place in?
Your answer
Contact Person's Name
Your answer
Contact Person's E-mail Address
Your answer
Submit
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