Steps for Real Second Chances Registration Form
Join the Center for Improving Youth Justice during our Steps for Real Second Chances event from April 1 - 30.
Name
*
First Name
Last Name
Email
*
example@example.com
Are you registering a team or as an individual?
*
Team
Individual
Not sure yet
Other
Name of Team Captain
*
First Name
Last Name
Email Address of Team Captain
*
example@example.com
Team Name
*
Total Number of Team Members
*
Please share your best estimate of the number of people who will participate on your team.
Who will be on your team?
*
Young people at our facility or program
Program staff
Family members
Other community members
Other
How will you track your steps?
*
Daily
Weekly
One-time event
Other
Are you a member of the Center for Improving Youth Justice's Performance-based Standards program?
*
Yes
No
Other
Facility or Program Name
*
Please enter as it appears on the website.
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
*
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