Assignment 808 - Program Registration & Request

Select Program or Speaking Option

Program 1: Career & Life Decision Workshops (45 min - 15 hrs) Assessments Included
Program 2: Creative Impact Academy (4 hour Youth Training Sessions) Ages 12 to 21
Program 3: Parent Empowerment Workshops (45 min - 1.5 hrs)
Speaker Option 1: Feature Speaker (15 min or less)
Speaker Option 2: Impact Talks (30 - 45 min) Orgs, Conf, Colleges, etc.
I have a different request.

Completing this form does not guarantee acceptance into 808 programming or secure requested services. A team member will follow up within 48 hours. Select YES if you understand this statement.

Yes
No

Who is completing this form?

Parent or Guardian
Community Organization or Business Rep
School, College or Educational Institution Rep
Judicial System or Correctional Facility Rep
Child completing pending Parent Approval
Other

Name of Person Completing this Form

Program Participant Full Name (if applicable)

Contact Number

Email

Participant or Organization Physical Address

If this is an Event Request, please state the City and Zip Code where event will be held.

In order to better serve you, please explain your request and expectations further.

Age Group of Youth (if applicable)

13 to 17
18 to 21
College

Grow with Intention! Request Talent & Strength Assessments.

Youth Group: Administer written Talent & Strength Assessments
Parent Group: Administer written Talent & Strength Assessments
School or College Class: Administer written Talent & Strength Assessments
Business or Organization Staff: Administer written Talent & Strength Assessments

808 Program Registration & Speaker/Assessment Request Form