Civic Youth Leadership Academy: Registration
Hello and thank you for registering the Civic Youth Leadership Academy, hosted by the Department of Neighborhood Empowerment.

Due to the COVID-19 pandemic, this program will be held virtually on Mondays July 13th, 20th, 27th, and August 3rd from 10-12 am on Zoom.

Please answer these questions before our first session. The goal of this survey is to gather baseline responses so that we can evaluate the program moving forward. Your answers are anonymous and demographic data is being collected for informational purposes only.

We look forward to meeting you this upcoming Monday, July 13th, 2020!  
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First Name *
Last Name *
Address *
City, State, Zip Code *
Cell Phone Number *
Name of School/University *
Grade Level *
What is your age range? *
What is your Gender Identity?
Clear selection
What is your ethnicity? Please check all that apply.
Which Neighborhood Council's area do you live in? If you don't know, visit https://neighborhoodinfo.lacity.org/  and enter your address to find out.
Have you been counted in the 2020 US Census?
Clear selection
Have you ever attended a City Council or Committee meeting? (City of Los Angeles or other local government)
Clear selection
Have you ever attended a Neighborhood Council meeting?
Clear selection
Do you think your voice can be heard by City decision makers?
Clear selection
Would you consider yourself an activist?
Clear selection
Why would you like to participate in the Civic Youth program and what are you hoping to take away from the experience?
What career are you interested in pursuing? If you don't know, what is an industry you are interested in?
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