IBBHI 2025 Interest Form

2025 IBBHI Participation Form

Please complete and submit this form to share your contact information with the Indiana Commission on the Social Status of Black Males, Indiana Black Barbershop Health Initiative, and our IBBHI Volunteer Coordinator.

We look forward to your participation in Indiana's Black Barbershop Health Initiative for 2025!

For more information on previous years of IBBHI, view our website: www.in.gov/icssbm/ibbhi/

If you have any questions / technical difficulties, please email: Gabriel Kramer at gkramer@icrc.in.gov

Gabriel Kramer

Cultural Commissions Coordinator/External Affairs Coordinator

Indiana Civil Rights Commission | gkramer@icrc.in.gov
Tell us About Yourself!

Your answer will direct you to the correct form.
Your Name*

First NameLast Name
Phone Number*
Please enter a valid contact phone number. (If one isnt available, enter (000) 000-0000 as a placeholder to bypass required field)
Email*
example@example.com
What is Your Role?*

Community LeaderBarbershop OwnerNon-Medical VolunteerMedical VolunteerStatewide Referral PartnerSponsor

2025 IBBHI Statewide Referral Partner Participation Form

In honor of everyone's time, this year we will be setting up a time for all statewide referral partners to present to all community leaders, volunteers, and barbers about the services they offer.
Your availability for virtual 2025 IBBHI referral partners presentation:

Weekdays after 5pm ESTWeekday before 5pm ESTWeekends before 12pm ESTWeekends after 12pm EST

2025 IBBHI Sponsor Interest Form

We will contact you with your contact info given above on the Sponsorship Info tier you have selected.
Which Sponsor Type are you Interested In?

Statewide SponsorCommunity Level SponsorInfo on Both
City / Location
Should be Empty:

Barber Capes / T-Shirts