*1.Student's First Name(Required.)

*2.Student's Last Name(Required.)

*3.What is your email address?(Required.)

*4.What is your phone number?(Required.)

5.Student Information

Address

City/Town

State/Province

AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming

ZIP/Postal Code

6.What is your gender?

Male

Female

Other

7.What is your race? (select one or more)

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

Indigenous or Alaska Native

Native Hawaiian or other Pacific Islander

Prefer not to Answer

*8.Anticipated High School Graduation Year?(Required.)

2023

2024

2025

2026

2027

*9.What school do you currently attend?(Required.)

*10.What Cause Inspires You?(Required.)

Antibullying

Hunger

Veterans

Homelessness

Disabilities

Environment

Youth

Animal Welfare

Education

Healthcare

11.What's your plan for college? (optional)

I don't plan on attendingI plan on attending a two-year institutionI plan on attending a four-year institutionI plan on attending a trade school

12.What's your general career interest? (optional)

Agriculture, Food and Natural ResourcesArchitecture and ConstructionArts, Audio/Video Technology & CommunicationsBusiness Management & AdministrationEducation & TrainingFinanceGovernment & Public AdministrationHealth ScienceHospitality & TourismHuman ServicesInformation TechnologyLaw, Public Safety, Corrections & SecurityManufacturingMarketing, Sales and ServiceScience, Technology, Engineering & MathematicsTransportation, Distribution & Logistics

*13.My service story or idea for how students can help end bullying.  (400 words or less):(Required.)

14.Attach any photos you would like to share of you completing your service.

Choose FileNo file chosen

*15.Would you like to be featured on a Humanity Rising Podcast? (Required.)

Yes

No

*16.Accept the terms below.(Required.)

I am at least 13 years old, have the permission of a parent or guardian and accept all “Terms & Conditions” posted on the Humanity Rising site. I understand that my service story may be published on HumanityRising.org and Humanity Rising social media accounts.

If you'd like to create a 60-second video to enhance your written submission, please use this link and the hashtag #riseup2024.

Remember to speak from your heart!

https://humanityrising.editmate.com/

(then enter #riseup2024)

By submitting a video, you give us permission to post it on social media or other digital platforms, including our website.