Register for the Youth Power Summit Step 1 of 4 25% About YouName(Required) First Last Date of Birth(Required) MM slash DD slash YYYY Are you(Required) 18 years old or older 17 years old or younger Home Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your Email(Required) Enter Email Confirm Email Phone(Required)School / OrganizationGrade LevelPreferred Pronouns Parent/Guardian InformationApplicants under 18 will be required to receive their parent or guardian’s permission to attend. Submit your parent/guardian’s contact information and the New Jersey Institute for Social Justice’s staff will send them the necessary forms to complete on your behalf. Name First Last PhoneParent Email Enter Email Confirm Email Applicant QuestionsWhy does youth power mean to you and why is it important?(Required)Do you have any experience with civic engagement, community organizing, or advocacy? If so, briefly describe your experience. * Your answer to this question will not affect your application.(Required)What issue areas are you most interested in advocating on?(Required) Democracy and voting rights Criminal justice Economic justice Housing Environment/Climate Education Healthcare Other Other Additional InformationDo you have any dietary restrictions? Select all that apply(Required) Vegetarian Vegan Gluten Free Halal Kosher No Dietary Restrictions Other Please describe any serious food allergies belowT-Shirt Size(Required)SMLXL2XLDo you require any special accommodations to participate in this event?Will you need transportation assistance?* Assistance may include free NJ Transit bus tickets, free NJ Transit train tickets, or a bus pick up. NJISJ will work with you to determine the best option for your needs.(Required) Yes, I'd like free bus tickets Yes, I'd like free train tickets No, I don't need transportation assistance What NJ Transit bus and/or train stop will they be traveling from?(Required)Do you have access to a smartphone or device that can be used to display a digital ticket?(Required)YesNoHow did you hear about the Youth Power Summit?(Required) Social Media (Facebook, Instagram, X, YouTube, etc.) Search Engine (Google, Bing, etc.) Email Institute website Sponsor organization Other Other
