Name *
Name
(e.g. he/him, she/her, they/them, he/them, she/them, etc.)
(e.g. Filipino, Black, Oromo, Latinx, White/Chinese, Somali, Mexican, etc.)
Birth Date *
Birth Date
Phone *
Phone
(If in Seattle, what neighborhood?)
Are you in school? *
Do you have a case manager? *
What is your primary mode of transportation? *
If the Metro bus is your primary mode of transportation, do you need help getting bus tickets?
Do you have any safety concerns we should know about? *
What are your musical interests? *
(Choose at least one)