Youth Interest Form

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Youth Interest Form

Thank you for your interest in enrolling your child into Michiana's brand new mentoring and family advocacy organization, Resonant Vibe!

Please fill out this interest form and when we begin accepting applications we will contact you to fill out a full application.

It would be super helpful if you could fill out one form per child.

Questions? Contact Denise: denise@resonantvibe.org or Katie: katie@resonantvibe.org

Your First and Last Name *

Your Email *

Your Phone Number *

Your Child's First and Last Name *

Your Child's Age (Kids must be age 6 and older) *

The county you live in: *

Elkhart

St. Joseph

Other:

What are you interested in? Check all that apply:

Youth Mentoring - you'd like a mentor for your child.

Parent Mentoring and Advocacy - you'd like help navigating educational, healthcare or governmental systems (DCS, Medicaid, etc.)

Community Organizing - you'd like to gather with others for events and learn ways to make changes in the community.

Board Member or Parent Advisory Council Member

All of the above.

To prevent spam: What is 4 + 4? *

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