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InspireNInnovate Program Interest Form
Which program(s) are you interested in?
Entrepreneurship
Branding and marketing
Financial literacy
Leadership development
Mentorship
Workforce readiness
Career exposure
Digital skills
Who are you?
Student
Parent/Guardian
School staff
Community organization
Referring professional
Other
First name
*
Last name
*
Email
*
Phone
*
Organization / School Name
*
Your Title / Role
*
Why are you referring this student?
*
What support or opportunity would be most helpful?
*
Are you interested in partnering with InspireNInnovate?
*
Student/Youth Full Name
*
Youth Age
*
Current Grade
*
School Name
*
Neighborhood / City
*
What are you most interested in?
*
T-Shirt Size
*
Special Skills
Accessibility Needs
Emergency Contact Name
*
Emergency Contact Phone
*
Photo/Video Consent
*
Yes
No
Newsletter Opt-In
Do you have basic Canva/tablet skills?
Yes
No
If “Tech Helper” selected
I give InspireNInnovate permission to contact me about programs and opportunities.
Yes
No
Link to portfolio or social handle.
If “Photography / Social Media” selected
Apply
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