"The Glow Project" Registration Form

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Thank you for your interest in TRANSIT ARTS and our "Black Girls Glow+" Project! As a youth/young adult member you now have the opportunity to participate in this special project, as well as all programs of TRANSIT ARTS, a citywide youth arts development program of Central Community House.

"Black Girls Glow+" is supported by the Monica Terez Girl Power Fund of The Women's Fund of Central Ohio and Homage. TRANSIT ARTS works in partnership with the Ohio Alliance for Arts Education and numerous community partners. Our programs are provided at no cost to our members.

Participants should answer questions in sections 1 through 2. Parents/Guardians (or ages 18+) must fill out sections 3 through 7.

Participant's First Name *

Participant's Last Name *

Participant's Date of Birth *

YYYY

Participant's Gender and Preferred Pronoun *

Participant's Street Address *

City *

Zip Code *

Participant's Race (check all that apply) *

Black or African-American

Caucasian

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Multiple Races

Some Other Race

Required

Is the participant of Hispanic, Latino, or Spanish Origin? *

Yes

Is English the participant's primary language?

Yes

Clear selection

Is the participant an immigrant?

Yes

Clear selection

If yes, what is their country of birth?

What school will the participant be attending for the 2023-24 School Year

What grade will the participant be in for the 2023-24 School Year

Participant's Phone Number *

Participant's Email Address *

Which is the best method of contact? *

Phone Call

Text

In the event of an emergency or accident, please notify the person(s) below and please provide their relationship to you and their phone number(s): *

Please provide the name and phone number of the person who will be picking your daughter up from the session

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