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Building Bridges Beyond Violence - My View
Creative Writing Opportunity For Teen Dating Violence Awareness Month! DEADLINE FOR SUBMISSIONS IS APRIL 1st, 2022. Youth between the ages of 12-25 years old and live in Nevada County may participate.
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Preferred Frist Name (if different from above)
Your answer
Birth Date
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MM
/
DD
/
YYYY
Email Address
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Your answer
Phone Number
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Your answer
Street Address
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Your answer
City, State, Zip
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Your answer
If applicable, what school do you attend?
Your answer
Preferred Pronouns
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They/Them
She/Her
Ze/Zir
He/Him
Prefer not to answer
Other:
Required
CBV is a a safe space! To help us better serve our youth community, how do you identify? Click as many as are applicable.
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Queer
Straight
Bi
Trans
Gay
Lesbian
Questioning
Not sure
Prefer not to disclose
Other:
Required
Have you experienced dating violence in your relationships?
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Yes
No
Maybe
Prefer not to disclose
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