JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
REAL TALK, BROTHER
Please complete this survey to participate in the program. Should you have any questions, please email Shenice Huff at
shuff@urbanleagueok.org
. Thank you.
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone number
*
Your answer
Zip Code
*
Your answer
Are you over 18?
*
Yes
No
If under 18, what is your parent/guardian's name? If does not apply, type N/A.
*
Your answer
If under 18, what is your parent/guardian's contact number ? If does not apply, type N/A.
*
Your answer
Have any males in your family been involved in the justice system?
*
YES
No
Have any males in your family had a misdemeanor or felony whom the Urban League can assist with finding a job?
*
YES
No
Please let us know which barber/mentor referred you to this program.
*
Your answer
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
Forms
