2025 Independent Living Graduation Celebration Registration
Graduating is a monumental milestone in life and we want to make sure ALL of our youth are celebrated (high school/GED)! Please fill out the form below to register for our 2025 IL Graduation Celebration, which will be held on May 3rd, 2025 at the Harbert Center in Birmingham, AL. Once registration has been completed, more details will be sent directly.
Graduate's Name
*
First Name
Last Name
Graduate's Preferred Name
*
Graduate's Gender
*
Male
Female
Non-Binary
Other
Graduate's Race
*
Asian/Pacific Islander
Bi-Racial/Multi-Racial
Black/African American
Native American
White/Caucasia
Graduate's Ethnicity
*
Hispanic
Non-Hispanic
I wish not to not disclose
Graduate's Email
example@example.com
Graduate's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Graduate's Home Address/Group Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Graduate's County
*
Name of School/Institution Attended
*
Diploma/Certificate/Degree Received
*
Date of Graduation
*
-
Month
-
Day
Year
Date
Are there any special achievements, recognitions, etc. we should know about? (Valedictorian, 4.0 GPA, Clubs, etc. ) If none, enter N/A.
Plans Post Graduation (College, Military, Employment, Etc.) if the program or educational institution is known, please share. If undefined, enter N/A
Social Worker's Name
*
Social Worker's Email
example@example.com
Social Worker's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How many guests will be in attendance?
*
Please Select
None (besides graduate)
1
2
Each youth is allowed to invite 2 guests (with social worker approval)
Is the graduate interested in a professional celebratory graduation photo?
Please Select
Yes
No
Submit
Should be Empty: