One moment please...
2024 STEAM DAY
Saturday, February 3rd, 2024
11:00am-4:00pm
(Check-in begins at 10:30)
Location: Seattle Public Library
1000 4th Ave, Seattle, WA 98104
For more information about STEAM Day, you can
click here
.
If you have any needs or questions, please contact Cheryl (she/her) at
cheryl@y-we.org
.
Y-WE Inclusion Policy
*Y-WE welcomes those who identify as a girl/woman, nonbinary, trans, and gender expansive.
Contact Information
Name
*
First Name
Last Name
What are your gender pronouns? (optional)
she/her, they/them, he/him, etc.
What is your age range?
*
select one
13-19
19-24
25 and above
Email
*
Verify Email
*
Phone Number
*
Do you have any dietary restrictions or food allergies? (for example: vegetarian, halal, allergic to peanuts, etc).
*
Do you have any medical considerations or major allergies we should know about in the event of an emergency? (for example, anaphylactic bee allergy, diabetic, etc)
*
Are there any accommodations you need to make this program accessible and comfortable? (physical space needs, technology support, environmental sensitivities, etc). If none, please write 'none.'
*
Y-WE is dedicated to creating inclusive spaces and programs for all, including people with disabilities and specific accommodation needs.
Will this be your first Y-WE event/activity?
*
select one
Yes, I am new to Y-WE
No, I have been in programs or gone to other events before
How did you hear about Y-WE?
Demographic Information
Y-WE collects this data to better understand who we serve, and to improve and obtain support for our programs. Your answers are confidential and will not be shared outside of Y-WE except as part of anonymous percentages.
Are you willing to answer a few short demographic questions? This information helps Y-WE better understand who we serve and obtain support for our programs. Answers are confidential and not shared outside Y-WE except as part of anonymous percentages.
*
Select 'Yes' to see the questions. If you change your mind, just reselect 'No' and the questions will disappear. All questions have a 'prefer not to answer' selection if you'd like to skip some questions.
select one
Yes
No
Do you identify as Black, Indigenous, or a Person of Color?
*
select one
Yes
No
Prefer not to answer
Other
If you selected 'Other' please describe (optional)
Race/Ethnicity (check any/all that apply, or select 'prefer not to answer')
*
American Indian or Alaska Native
Asian
Black
African American
African
North African
Hispanic or Latino/Latinx
Middle Eastern
Mixed Race
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Other
If you selected 'Other' please describe (optional)
Gender Identity (select any/all that apply, or select 'prefer not to answer')
*
Agender
Girl or woman
Boy or man
Non-binary
Genderqueer
Transgender
Gender neutral
Two spirit
Cisgender
Genderfluid
Prefer not to answer
Other
If you selected 'Other' please describe (optional)
Do you identify as LGBTQIA+? (select any/all that apply, or select 'prefer not to answer')
select one
Yes
No
Other
Prefer not to answer
If you selected 'Other' please describe (optional)
Emergency Contact
For participants under 18, the emergency contact must be a parent/guardian.
Emergency Contact Name
*
First Name
Last Name
Relationship to Participant (parent, spouse, friend, etc)
*
Emergency Contact Phone Number:
*
Emergency Contact E-mail Address:
Verify Email
Thanks for your application!
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