Youth & College Activation Form

Who are you!?

Let us know who you are so we can stay in contact with you throughout the year.
Hey, how do we spell your first & last name?*

First NameLast Name
Do you have a preferred phone number and email?*

Area CodePhone Number
Email*
example@example.com
What's your zodiac sign🕺🏾!? Whoops, got carried away🙃 when is your birthday?*

MonthDayYear
State*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Fall Programming & Campaign Selection
Ok, you came here to do work. Which program/activation are you interested in?*

Rise Up: Membership Campaign (All Units)Vote 4 Me Campaign (Members under the age of 18)More Than A Month Mobilizer (All Units)Advisor Retreat (Advisors)Fired Up Civic Leadership Summit (VA & MS)
Select Proposed date of Truth Screening - A represenative from Truth will contact you with next steps.

MonthDayYear
Date
Should be Empty: