PEACE Birmingham 2021-2022 Student Application
PEACE Birmingham is a monthly dialogue group for teens from different cultures and faiths with the goal to create doors through which we can enter each other's communities to nurture and sustain a Birmingham that values and welcomes people of different race, religion, creed, nationality, school, gender, sexual orientation, immigration statues, ability, and cultural background. PEACE provides a safe, welcoming, open environment in which issues such as stereotypes and prejudice are discussed.

Please fill out the form below if you are interested in participating in PEACE Birmingham and we will contact you with more information. The program will begin in September 2021 and end in April 2022.
Sign in to Google to save your progress. Learn more
Full Name *
Preferred First Name *
Email *
Phone Number *
School *
Current Grade [2021-2022] *
Age *
What is your Race/Ethnicity? *
What is your Religion, Faith Identity, or Philosophy of Life? *
Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Have you ever participated in PEACE Birmingham, Anytown Alabama, or Heritage Panel? Check all that apply. *
Required
What do you think are the biggest social justice issues in your community? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of AlaQuest Collaborative for Education. Report Abuse
Google Forms