Reach Academy for Young Men 2022
June 13 - July 1, 2022

COURSE REGISTRATION

Location:  All Saints Episcopal Church:  504 N. Camden Road, Beverly Hills, CA 90210.

We are excited to welcome you!  Please fill out each of the following questions thoroughly.  

When choosing courses, keep in mind that there is one choice per time slot.  Courses close once filled.

ONCE YOU HAVE FILLED THIS FORM, YOU MUST REGISTER THROUGH EVENTBRITE:  https://www.eventbrite.com/e/reach-academy-for-young-men-summer-institute-2022-tickets-324485092647

Your course selections will not be confirmed until your Eventbrite registration has been finalized.

***If you seek scholarship, please email info.reachacademy@gmail.com
Sign in to Google to save your progress. Learn more
Participant's Full Name (First, Middle, Last) *
Participant's Nickname (if applicable)
Participant's Preferred Email *
Participant's Teacher Recommendation
Please select one teacher (or alternate adult - coach, mentor, etc. who knows your son) from this current academic year to complete our recommendation form.
*This is a required step in registration.  
Teacher Name (First, Last), School, subject area, grade level, and contact information (must include email) *
FOR THE PARTICIPANT:  Why do you choose this teacher? *
Parent/Guardian #1 Name *
Parent/Guardian #2 Name (if applicable)
Parent/Guardian #1 Mailing Address *
Parent/Guardian #2 Mailing Address (if applicable)
Parent/Guardian #1 Phone Number (please indicate cell, home, office) *
Parent/Guardian #2 Phone Number (if applicable - please indicate cell, home, office)
Parent/Guardian #1 Preferred Email *
Parent/Guardian #2 Preferred Email (if applicable)
Participant's Age (Years/Months) *
Participant's Birthday and Year of Birth *
Participant Allergies *
Participant's Dietary Preference(s) *
Participant School in Fall 2022 *
Participant Grade Level in Fall 2022 *
How did you first hear about Reach Academy for Young Men?
FOR THE PARTICIPANT:  What are some goals you hope to achieve by attending Reach Academy For Young Men? *
FOR THE PARTICIPANT:  What are three things we should know about you? *
FOR THE PARTICIPANT:  Who is someone you admire and why? *
Weeks for Enrollment:  Please check all boxes that apply.  Three weeks is expected in order to receive the full experience, although one or two weeks can also be accommodated. *
Required
Week One - Period One
Week One - Period Two
Week One - Period Three
Week Two - Period One
Week Two - Period Two
Week Two - Period Three
Week Three - Period One
Week Three - Period Two
Week Three - Period Three
Son's t-shirt size (adult size only) *
To Confirm registration, CLICK THE EVENTBRITE LINK (below)
https://www.eventbrite.com/e/reach-academy-for-young-men-summer-institute-2022-tickets-324485092647
This is required in order for enrollment to be confirmed.  Contact info.reachacademy@gmail.com with questions.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms