Intern With Us!Sign up for the Summer 2025 Cultivating Youth cohort. Youth Name * First Name Last Name Youth Email if you have an email address that you check often please list it here. Youth Phone (###) ### #### Age * Birth Date * MM DD YYYY Gender * Male Female Other/Non-binary Preferred Pronouns * Please share your pronouns with us so that we may address you correctly Youth Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian Name * Skip if you are over 18 First Name Last Name Parent/Guardian Phone Skip if you are over 18 (###) ### #### Parent/Guardian Email Skip if you are over 18 How do you prefer to be contacted? * Tell us how to get in touch with you Text Me Call Me Email Me Call My Parent/Guardian Why do you want to participate in this program? * Can you commit to all four weeks of the program? * Programming is scheduled Tuesdays 12pm-8pm, Wednesdays and Thursdays 11:30am-6:30pm from July 8th to August 14th. Some Saturdays. Yes No If you answered no above, please explain why Include which dates you are unavailable Have you participated in this program before? * Yes No Are you eligible for free or reduced lunch? Yes No What is your t-shirt size? Adult Unisex Fit XS S M L XL XXL I need a size not listed here Do you have any dietary preferences or food allergies we should know about? Please share them with us here. Thank you!
