AHS YP 2025 Registration

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Asian Health Services Youth Program (AHSYP) in Oakland Chinatown supports youth in their journeys towards becoming healthy and thriving community members and leaders. With various programs and plenty of room to touch base on topics including mental health, reproductive health, and additional health resources, AHSYP caters to the current needs of the community.

First Name *

Last Name *

Is this your preferred name?

Yes

Other:

Birthday

YYYY

Gender

Male

Female

Other:

Race

Black/African American

Native American/Alaskan

Hispanic or Latinx

Native Hawaiian/Pacific Islander

White

Asian

Other:

Ethnicity (If Asian)

Chinese

Japanese

Korean

Vietnamese

Filipino

Indian

Mien

Laotian

Cambodian

Thai

Other:

Preferred Language

English

Spanish

Cantonese

Mandarin

Tagalog

Vietnamese

Other:

Address

City

Zip Code

School

Grade

Phone Number

Which of these are okay with you?

Call

Text

Voicemail

Other:

Preferred Contact

Phone

Other:

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Emergency Contact Name

Emergency Contact Relation

Parent

Guardian

Sibling

Grandparent

Friend

Other:

Emergency Contact Phone Number

Programs you're joining with AHS Youth Program: (dates listed are for summer 2025 cohort)

C.H.I.L.L. (Mental Health & Self Care) | Jun 9 - Jul 30 | M/W 4-5:30pm | $150 Stipend | Virtual

CCSC (Cross Cultural Solidarity; Working for a change in your community) | Jun 12 - Aug 14 |Thur 12pm-1pm | $150 Stipend | Hybrid

Over The Rainbow (Safe Space for Queer youth and like-minded individuals) | TBD | Hybrid (in-person and virtual)

Youth Volunteers (Ages 12-25) | Times Vary | Compensation: Volunteer Hours

Which of the following do you prefer?

In-Person Programming

Online Programming

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How did you hear about us?

AHS YP Staff

AHS YP Social Media (Instagram, Facebook, etc.)

Flyer

Friend

School

Other:

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