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Y-WE Nature Connections 2017-2018

Fall 2017 to Summer 2018

Youth Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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(mm/dd/yyyy)
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If you have it, this is our preferred and BEST way to reach you. If you put your cell as your "home" phone, simply re-type it here.

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What will be your grade-level in the 2017-2018 school year?


i.e. she/her, they/them, etc.

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Y-WE is dedicated to creating inclusive spaces and programs for all, including people with disabilities and specific accommodation needs

Y-WE will make sure that rides are available to participants who need them. If possible, we will ask you and other participants in your region to meet at a central location near your home so that a Y-WE shuttle can pick up a bunch of participants at the same time. If there is no central meeting spot in your area, we will send someone to your home to pick you up.

Parent/Guardian/Emergency Contact Info
TO BE COMPLETED BY PARENT/GUARDIAN. Please fill this section out completely so that we can contact you about upcoming events and notify you if any emergency situation were to arise while this young person is at our program.
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country


Emergency Contact #1
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First Name
Last Name
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Emergency Contact #2
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First Name
Last Name
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Youth Y-WE Program Interests
Your answers to these questions help us to get to know you better and understand what inspired you to apply to Y-WE. We shape our programs around the passions and goals of the youth who participate--so your answers to these questions really matter to us! This program is here to support YOU in the best way possible.
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Your Commitment to Attending Y-WE
We have limited space in all our programs and we require a commitment from you to participate in all activities related to the program you are signing up for. If you miss our events regularly, without pre-approval from the program team, we may ask you to leave the program and offer your spot to someone else.
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Program Cost
Y-WE is available to any young woman or gender non-binary youth who wants to participate, and no one will be turned away due to inability to pay. The full cost of Y-WE for each participant is $1,000. Any amount over $1,000 that you contribute is tax-deductible and will be added to our scholarship fund so that other youth in need can have this life-changing opportunity.
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