Vayla RJ Interest Form
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Our Summer Program session will be held over Zoom. You will be able to access it so long as you have access to a phone or computer. If this should be an issue, please reach out to us by emailing ellen@vayla-no.org.

We will determine the summer program's schedule on the majority's availability.
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Email *
Name *
What are your pronouns? (i.e. she/her/hers) *
Do you identify as a person of color? If so, feel free to identify your race and/or ethnicity. *
Have you previously received any formal or informal sex education? *
If yes, where did you receive that information? (School, after school program, media, etc.)
What school do you attend? *
What grade will you be in this upcoming fall? *
What is your summer availability for the RJ Program? Do you have other priorities that may conflict? *
Please provide your parent or legal guardian's email address: *
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