Mental Health Thru Music & Creative Arts Sign Up!
Calling ALL young creative artist ages 13-17 years in music, art, film & culinary arts highlighting mental health! Envision Youth Services is a non-profit mentor program supporting underserved youth. Join us for our "Mental Health Through Music & Creative Arts" program filled with empowering workshops in mental health, music development & creative arts through culinary & film. Program services LA County youth. Pre-register for our November sessions by filling out this form, space is limited!! Visit our website for more information www.envisionyouthservices.org
Main Contact First & Last Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social Media Handles:
Facebook, Instagram, Youtube
Early interest Youth Participant?
Please Select
Yes
No
If Yes, continue to the next question.
Child's Full First & Last Name
First Name
Last Name
Child's Age
Child's School
Child's Grade
Option of Interest
Donate Now
Mental Health Workshop
Music Development Workshop
Creative Arts Workshop
Sponsor
Volunteer
Partner
Location
Compton
Los Angeles
Long Beach
Mental Health through Music & Creative Arts Contribution
prev
next
( X )
USD
Donation
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Submit
Should be Empty: