Thank you so much for your interest in launching a BC2M club at your school! Our club program typically works to launch new clubs within specific regional hubs. Our current regions are Northern CA, Southern CA, Phoenix AZ, and New York City. However, we do work with a limited number of schools outside of these areas. Due to high interest from schools across the country, we ask those interested in starting a BC2M club to fill out this application form in order to qualify. Based on your geographic region, the answers you provide, and if a spot becomes available for your school, a BC2M staff person will be in contact.

Questions? Email us at highschool@bringchange2mind.org

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* 1. Full Name

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* 2. Best email address to reach you

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* 3. Name of School

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* 4. City and State of School

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* 5. Your Position within the School

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* 6. Currently, how is mental health talked about at your school and within your community? How (if at all) would you like this to change?

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* 7. Why are you interested in launching a BC2M club at your school?

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* 8. Please share email addresses for students and staff members interested in participating in a future BC2M club at your school.
(Please separate addresses with a comma. This will add them to the mailing list for BC2M HS's bi-monthly newsletter.)

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* 9. Is there a group of passionate student leaders ready to launch this student-led club? Please elaborate. 

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