"I'm With You" Teen Retreat Application Form
(Funded by the U.S. Department of State and administered by World Learning, Inc.)

This intensive, interactive weekend retreat will empower young Asian American Pacific Islander (AAPI) girls ages 14-18 with the strategies, rhetoric and confidence to address sexual violence in their communities. Participants will learn the skills necessary to become leaders of social change for other AAPI girls and women.

There is no cost to participate in the retreat, but registration is required.

When: June 23 - June 25, 2017
Time: 5 PM June 23 (Fri) - 11 AM June 25 (Sun)
Location: Saint Cloud State University (SCSU) campus (720 4th Ave S, St Cloud, MN 56301)
Phone contact: Amy Tran, 701.403.9702
Email contact: amy.tran02@gmail.com

Email address
Full Name (First, Middle, Last)
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Mailing Address (Street, City, State, Zip Code)
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Home Phone Number
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Alternate Phone Number
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School & City
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Grade (in school)
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Age (Participants under the age of 18 will need a consent form from a parent or legal guardian)
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This retreat requires two overnight stays at Saint Cloud State University (SCSU) campus dormitories with adult chaperones.
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