Stop The Killin - Peace and Unity Project
Registration Form (No violence or disrespect will be tolerated by or toward anyone).
Your Reason For You Registering? (Please select all that apply).
You would like to register yourself or your community area to join our money team.
You are signing up to become a representative from and for your community area.
You would like to become a Accountability Team Member.
You would like to become a volunteer at our facilities or events.
You would like to provide services.
You are signing up as a court referral or for community service (if so, please we know we do not accept people with a history of rape, sex abuse or sexual assault).
Full Name
First Name
Last Name
Age
Sex (Please select Male or Female).
Male
Female
10 Digit Phone Number (Example: 5555555555)
Email Address (Note: Please be sure you have your correct/valid email address).
example@example.com
Are you U.S. Veteran? (Answer Yes or No).
What Community Area Are You From or Located in? (Please add your city and zip code for now and we will inquire about your affiliation during our in-person interview along with someone as your community area representative). Example: Los Angeles - 90044.
What services are you interested in receiving? (Select all that apply).
Vocational / Job Training.
Educational (GED or College Preparation).
Anger Management
Housing Assistance (Homeless Services).
N/A or None.
What Training, Programs and Events would like to participate in? (Select all that apply)
Join Our Money Team As A Promoter and Affiliate.
Business Start-up / Entrepreneurship Training.
Job Placement / Job placement Assistance.
Employment Opportunity Through Our Independent Music, Film and TV Projects.
Possibly Win Cash Prizes As An Artist In Our Up-coming New Talent Show Cases.
Attend Our Shows/Events and Possibly Win Cash Prizes and Give-Aways.
N/A or None.
How Did You Hear About Us? (Select all that apply).
A Community Representative
Received An Email
A Social Media Page
News Paper
Radio / Podcast
Other
Please verify that you are human
*
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