DAI Training Registration for AZYLF Graduates

Diverse Ability Incorporated Training Registration Form

For Arizona Youth Leadership Forum (AZYLF) Graduates
Diverse Ability Incorporated provides graduates of the Arizona Youth Leadership Forum (AZYLF) training opportunities designed to enhance their skills, boost their confidence, and increase their impact.

Please complete this form to register for upcoming training opportunities. If you have any questions or concerns, please email the pbs4youth inbox.
Training Selection

Please answer the following question, and the available training opportunities will be displayed.
Have you graduated from AZYLF?
I am interested in:
Arizona Youth Engagement Academy (AZYEA)
This hands-on training teaches youth and young adults how to be leaders and support their peers. Participants learn skills in presenting, public speaking, and peer-to-peer facilitation. They also receive training to help with Person-Centered Planning.

Open to: Any AZYLF graduate who has not taken this training before or wants a refresher.
Note: Attending does not guarantee paid work with Diverse Ability Incorporated.
Please select an AZYEA training:
Have you completed the Arizona Youth Engagement Academy (AZYEA)?
You must complete the Arizona Youth Engagement Academy before you can register for this training.
Person-Centered Planning (PCP) Refresher
Anyone who plans to lead Person-Centered Planning should take a PCP refresher each year. This training helps participants learn new strategies, improve their skills, and share experiences with others.

Open to: AZYEA graduates who want to refresh their PCP skills.
Required for: Anyone working with DAI to facilitate programs in schools.
Please select a Person-Centered Planning Refresher training:
Skills to Pay the Bills (Participant)

This training helps young people build important workplace and professional skills. It focuses on six key areas:
- Communication
- Enthusiasm & Attitude
- Teamwork
- Networking
- Problem-Solving & Critical Thinking
- Professionalism
Open to: Students* ages 14–22 with a documented disability* who live in Arizona.
Requirement: AZYLF graduates must complete this training before taking the Skills to Pay the Bills Facilitator training.

*High school, college, university, certificate program, other post-secondary training program, etc.
**Documented disability may include an IEP, 504 Plan, or medical documentation of a disability or diagnosis.

To register for a Skills to Pay the Bills (Participant) training, please visit our Skills to Pay the Bills Registration Form.
Have you completed a Skills to Pay the Bills training as a participant?
You must complete the Skills to Pay the Bills training as a participant to qualify for the Skills to Pay the Bills Facilitator Training. To register for a Skills to Pay the Bills (Participant) training, please visit our Skills to Pay the Bills Registration Form.
Skills to Pay the Bills Facilitator Training
This training prepares young people to lead the Skills to Pay the Bills curriculum and guide interactive activities.

Open to: Individuals who have completed the Skills to Pay the Bills Participant training.
Please select a Skills to Pay the Bills (Facilitator) training:
Young Adult Information
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
What county do you live in?
Date of Birth

MonthDayYear
Please choose the option(s) that apply to you.
High School Student ID Number
Expected High School Graduation Date
Month and Year
Post-Secondary Program Graduation/Completion
Month and Year
What is your disability/are your disabilities?
Are you a minor or under guardianship?
Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last Name
Relationship to Participant
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Format: (000) 000-0000.
Accommodation Request
We are committed to making our events accessible to everyone. Please describe any disability accommodations needed to participate in this event. Note: Advance notice may be required to arrange for some accessibility needs.
Allergies and Dietary Restrictions
Do you have any known allergies (food, medication, environmental, insect stings, latex, other)?
Please list all allergies.
Please list allergies.
Do you have any dietary restrictions?
Please list any dietary restrictions.
Please list dietary restrictions.
Emergency Contact
Emergency Contact Name

Emergency Contact First NameEmergency Contact Last Name
Emergency Contact Relationship to Participant
Parent/guardian, friend, etc.
Emergency Contact Phone Number
Format: (000) 000-0000.
Media Consent and Release

Please read the Media Consent and Release terms and conditions. To confirm your understanding and agreement, check each applicable box, then sign in the space provided.
Participant Media Release Signature
Participant First and Last Name
I am a minor or have a legal guardian:
Parent/Guardian Media Release Signature
Parent/Guardian First and Last Name
Activity Participation Agreement with Release of Liability and Assumption of Risk Agreement

Please carefully review the agreement below. To confirm your understanding and agreement, check each applicable box, then sign and date in the spaces provided.
Participant Signature
Participant First and Last Name
Date

MonthDayYear
Parent/Guardian Signature
Participant First and Last Name
Date

MonthDayYear
Optional Funding Questions

These questions are for funding and grant purposes. You can choose to answer them or not; either way, it will not affect how we consider your application. If you do answer, your responses will help Diverse Ability Incorporated continue to provide free and low-cost programs for youth and young adults who have disabilities. Your answers are confidential, meaning we will not connect your name or any other part of your application to your responses. Thank you for your support!
Based on your household income, are you eligible for low-income assistance programs (e.g., Free and Reduced-Price School Meals, Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Food Distribution Program on Indian Reservations (FDPIR), etc.)?
Do you have a physical disability or a chronic health condition?
If you answered “Yes,” please check all that apply.

Other
If you have difficulty completing this online form, please email us or call 602-425-5135.
Should be Empty:

Diverse Ability Incorporated Training Registration Form

Training Selection

Young Adult Information

Parent/Guardian Information

Accommodation Request

Allergies and Dietary Restrictions

Emergency Contact

Media Consent and Release

Activity Participation Agreement with Release of Liability and Assumption of Risk Agreement

Optional Funding Questions