Get N' Formation Program (Feb-May 2017)
4 month program (running from Feb-May) that meets on Saturdays from 10-2pm. The best team will be able to an all expense paid trip to Baltimore, MD in July.
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Participant Name: *
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Participant Age: *
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Participant Phone Number: *
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Participant Address (street, city, state, and zip): *
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Participant Email Address: *
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Parents Email Address: *
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Parents Phone Number: *
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What grade are you in currently? *
What is the name of the school you are attending? *
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In the Health Equity and Wellness Program we are focusing on teaching students how to organize, collaborate, and learn communication tactics to create real change in their communities. *
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Why do you want to participate in the Health Equity and Advocacy Program? *
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What time would be okay to interview? *
Are you Available during the scheduled times of the Program? Orientation is Saturday February 25th at 10:00am to 2:00pm and the Health and Advocacy. Program runs from February 25th-May 20th meeting most Saturdays and over spring break. • Saturday Feb 25th • Saturday March 4th, • Saturday March 18th, • Friday March 24th (special field trip to Boulder to tour the University of Colorado campus-optional)• Wednesday March 29 (Spring break session)• Thursday March 30 (Spring break session)• Friday March 31 (Spring break session)• Saturday April 1 (Spring break session)• Saturday April 15• Saturday April 29• Saturday May 6th• Saturday May 13th• Saturday May 20th- *
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What most excites you about the program? *
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What makes you most nervous about the program? *
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Do you know what an activist is? If so, please explain below. *
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As mentioned above, this program teaches young women how to be activist, leaders, and advocates on health related issues. Please take some time to tell us about the health issues that you are most passionate about addressing? *
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Have you ever helped to create a change in your community or school? If so, what steps did you take? *
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What is a leader to you? *
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Do you think you are a leader? Why or why not? *
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What adult size t-shirt do you wear? *
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Do you have any other questions about the structure of the program? If so, please list them below and we will answer them for you when we speak to you during the interview. (This question doesn't make sense. These are the interview questions) *
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Here are a few reminders about dates. Remember you will get a reminder with this summary later on today. The orientation is February 4th at 10:00am to 1:00pm. The program is twice a month every other Saturday. A parent should come with you to the orientation to pay the fee.
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Is there anything we need to know about you?
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