2023 Youth Intake Form
This form is used so we can know more about who you are and how you describe yourself. Art from Ashes will keep your personal information confidential, and will not share it without permission from you or your legal guardian. If you give us your info, we may contact you (with your permission) to inform you of upcoming events we think may interest you. Thank you!
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Email *
Your Name *
Your name will be protected so you can answer these questions and the survey questions at the end with complete honesty. One person from AfA who doesn't know you will assign you a number to keep your answers confidential.
Today's Date *
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Date of Birth *
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If we want to reach you, can we email you? *
Postal Code *
Your Home County (or select "Not in Colorado") *
Where ya live.
If you don't live in Colorado, please let us know your state or your country.
Mobile Phone
If you don’t live in America, please use a country code, if you know it.
Emergency Contact Name and Phone Number *
How old are you? *
Which best describes you? *
Required
Are you a student in school, college or vocational training? *
Check whichever is true for you: *
If you're in elementary, middle or high school, what grade are you in?
What's the name of your school or the agency you're a part of? *
Which group are you with? Put "Art from Ashes" if you're at our on-site workshop, and "N/A" if you're not attending a school or participating with an agency.
Denver Public Schools Students only: School Lunch ID number
Which best describes you? *
How do you identify/What are your pronouns?
Which social media do you use?
If you're in a virtual workshop and want us to mail you a poet pin and a sticker for filling out this form, let us know your address here or by emailing programs@artfromashes.org
Any Other Things You Would Like to Share?
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