WCCUSD Community Forum - Parent/Guardian/Caregiver Interest Form
This is a form created by Healthy Richmond and partners for students of West Contra Costa Unified School District interested in participating in a parent and student led virtual community forum speaking their truths and experiences related to COVID, safety, and other issues.

What is a community forum? A community forum can be a 'meeting space' where you are able to engage in conversations with others to share knowledge and your perspectives.

When is the community forum? February 10th, 4:30pm - 6:30pm.

Where will the community forum be at? It will be held over zoom. You will receive a link to register after providing contact information below.

Please take the time to provide your input on how to design and facilitate the forum. We want to provide the platform for you all to imagine a safe and respectful space that we can help execute for you all.
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What is your first and last name? *
What is your email? *
What is your phone number? *
What is your preferred method of contact? *
If you selected 'Other' for method of contact, please describe the method of contact below.
Other methods of contact can include Facebook, Instagram, etc.
What days generally work for you? *
For example, you can reply with "Monday - Friday", "Monday, Wednesday, and Friday" or simply "Monday."
What times generally work for you? *
Please check off the identify the grade level(s) of your child(ren). *
Please check off the school(s) of your child(ren). *
Other than listening in the community forum as a audience member, would you like to collaborate with WCCUSD and Community Based Organizational Staff by fulfilling a role (e.g. facilitator, notetaker, creating the agenda, etc.)? *
If you answer 'Yes', we will contact you to further discuss ways in which you can help contribute.
Who do you want to be there in the virtual space with you for them to listen and support? *
If you selected 'Other' for who you want have in the virtual space, please describe them below. *
As a parent/guardian, what roles do you want other adults to take on during the community forum to support STUDENTS/YOUTH? *
Please check off the following boxes that you feel like are top priorities of concern that you have that you would like to have discussed during the community forum. *
If you selected 'Other' for priorities of concern, please describe them below. *
Even if you unable to attend the event, would you like to stay connected by joining our Schools and Neighborhoods Action Team? *
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