Question Title * 1. I am at least 13 years old: Yes No Question Title * 2. Student's First Name Question Title * 3. Student's Last Name Question Title * 4. What is your email address? Question Title * 5. What is your phone number? Question Title * 6. Student Information Address City/Town State/Province -- select state -- 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 Question Title * 7. What is your gender? Male Female Other Question Title * 8. What's your race? (select one or more) White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race Question Title * 9. Anticipated HS Graduation Year? 2019 2020 2021 2022 2023 2024 2025 Question Title * 10. What school do you currently attend? Question Title * 11. What Cause Inspires You? Antibullying Hunger Veterans Homelessness Disabilities Environment Youth Animal Welfare Education Healthcare Question Title * 12. What's your plan for college? (optional) I don't plan on attending I plan on attending a two-year institution I plan on attending a four-year institution I plan on attending a trade school Question Title * 13. What's your general career interest? (optional) Agriculture, Food and Natural Resources Architecture and Construction Arts, Audio/Video Technology & Communications Business Management & Administration Education & Training Finance Government & Public Administration Health Science Hospitality & Tourism Human Services Information Technology Law, Public Safety, Corrections & Security Manufacturing Marketing, Sales and Service Science, Technology, Engineering & Mathematics Transportation, Distribution & Logistics Question Title * 14. Your bullying solution and action plan: Question Title * 15. Attach any photos you would like to share of you completing your service. GIF, JPEG, JPG, PNG file types only. Choose File Choose File No file chosen Remove File Attach any photos you would like to share of you completing your service. Question Title * 16. Accept the terms below. 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. Submit My Solution
