Participant Interest Form

Participant Interest Form

Please fill this out so we can match your interests with opportunities to participate in various BRITE Programs
First Name*
Last Name*
Your Pronouns
What are the best ways to reach you? *Choose one or more. Note that some school email accounts block email from non-school accounts so you may want to include a personal email address below.

EmailPhoneTextAny of the above
Phone Number
Email
Which activities are you interested in (Choose as many as you like):*

Acting on CameraArt AdvocacyBRITE World (3D Environment)LeadershipLGBTQ+ Support/ResourcesMental Health/WellnessMusicReality Party for ParentsResource Table at Health FairsSocial Change Theatre / ImprovSocial Media CampaignsSpokesperson ExperienceVentura County Youth Leadership TeamVideo ProductionWritingAny of the Above
Date of Birth*

MonthDayYear
What languages do you speak or write?
What is the name of your school, group, or agency?
What city do you live in? *
How did you hear about BRITE?
Feel free to tell us anything else you think we might want to know.
Do you need us to track your hours for reporting to your teacher or other person? *

YesNo
To whom do we report hours?
Include name & contact Info
Should be Empty: