Youth Leadership Council @ McReynolds — Center for Urban Transformation

Guardian Name:

First Name

Last Name

Relationship to youth participant:

Youth Name:

First Name

Last Name

Preferred Language:

Best way to contact you (guardian)?

Guardian Phone:

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Guardian Email:

Youth Phone:

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I give permission for CUT to capture and use media (photo/video) of my youth.

Please share any allergies your youth has (Write "none" if no allergies).

What do you want to learn more about in the world of Community Engagement, Civic Leadership, and/or Critical Service?

This can be a passion, an interest, a skill, or a brand new topic for you!