Better Wiser Stronger Interest Form
Thank you for you interest in learning more about programs offered at Better Wiser Stronger. We offer a number of one-time, school-year, and summer programs for young men of color in grades 3rd-12th. Please complete this form to let us know which programs you are most interested in and we will contact you with next steps. If you have specific questions, please reach out to our Program Director at chamille@betterwsinc.com.
Student Information
Student Name
*
First Name
Last Name
Date of Birth
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Male
Female
Grade
*
Please Select
3rd
4th
5th
6th
7th
8th
9th
10th
11th
School Attended
*
Parent Contact Information
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Best Way to Contact
Email
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Program Interest
Select the program(s) you are most interested in participating in:
Program Offerings
*
Confident Reading - Literacy (3rd - 8th grade) starts Wednesday 9/23
Teach Me to Tie - Social and Emotional Development (5th-8th grade) starts Monday 9/28
Boys to Men - Social and Emotional Development (High School)
Blue Collar - Workforce Readiness (8th-12th)
Leadership Advisory Board (6th - 12th grade)
Academic Tutoring (5th-10th grade, additional grades upon request)
Other
Why are you interested in enrolling your child in programming from Better Wiser Stronger?
How did you hear about Better Wiser Stronger?
*
Family or Friend
School Counselor or Teacher
Social Media or Internet Search
Community Event or Resource Fair
Partner Organization
Other
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