Join us at 4pm-6pm, August 8th-19th Monday through Friday, for our ACT Institute. This summer, participants engage in activities and exercises focused on an increase understanding of themselves and their world.
We explore complex and necessary topics such as: culture, influence/bias, stress, place matters, identity matters, oppression, conflict management, and art activation. All while earning a stipend up to $225!

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* 1. Youth Participant Information

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* 2. How do you identify racially? (Please choose all that apply)

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* 3. How do you identify ethnically? Please self-identify. (Non Exhaustive Examples: African American, Anglo, Chicano/Chicana, French, Mixed Ethnicity, Mixed European Decent, Puerto Rican, Yoruba, etc.)

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* 4. What's your national origin? (Please name the country where you were born or share additional comments)

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* 5. What is your gender identity? (Please choose all that apply)

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* 6. What are your pronouns? (Please choose all that apply)

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* 7. What is your sexual orientation? (Please choose all that apply)

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* 8. What is your first language?

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* 9. What is your (family) class position?

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* 10. How do you identify related to ability and access? We recognize the terms below are not a complete reflection of the diversity in experience of ability and accessibility. Nor does it capture the variation in needs for accommodations if you do not see an identifier that represents you, please self identify in the area provided.

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* 11. What is your Religious/Spiritual Affiliation?

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* 12. Communication, Collaboration and Conflict:

  Disagree Somewhat Agree Agree Strongly Agree
I am confident working with people who are different than me.
I am confident with talking things through when conflict arises.
I am confident expressing my feelings and ideas.

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* 13. Mental Health

  Disagree Somewhat agree Agree Strongly Agree
I understand what mental health is.
Mental health is important to me.
I understand the relationship between mental health and culture.

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* 14. Identity:

  Disagree Somewhat agree Agree Strongly Agree
I understand the importance of knowing the culture and identity of my teachers and classmates.
I understand the importance of knowing my culture and identity.
I know my culture and identity.

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* 15. Art

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* 16. Is there anything else that you would like us to know (questions, comments, or concerns)?

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