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06/23/09

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"Networks"
Community Empowerment Initiative
Building a better community through the power of Young People
"We do it Better!"

Please fill out the following online form:

 

Two Ways to Sign-Up

1. Click Here to Download Forms, print them, and return the to our office: 250 East Apache (West Office Entrance of the Gathering Ground/Call 918-582-9675 to make an appointment.

or

2. Fill-out the online form below and pay with Debit Card, Credit Card, or PayPal Account:

Name
  
Address
  
City
  
State
  
Zip
  
Phone
  
Email
  
Child1 Name
Child1 Age
Your Relation to Child1
Child2 Name
Child2 Age
Your Relation to Child2
Child3 Name
Child3 Age
Your Relation to Child3
Child4 Name
Child4 Age
Your Relation to Child4
Child5 Name
Child5 Age
Your Relation to Child5
Donation $5/month per house
$10 for 2 months, $15 for 3 months, $30
for 6 months, and $60 for 12 months, etc.		 

By filling in the date and submitting this form you acknowledge understanding and awareness that in the event that your child(ren) is injured while working at any particular job, the Youth Employment Initiative/Empowered Youth Tulsa will not be liable or financially responsible for any injury that could be incurred. Businesses or civic organizations will not be responsible for any injury incurred.

Tulsa Public Schools facilities and advertisement has been used and Tulsa Public Schools fully supports the efforts; however, Tulsa Public Schools is not an official partner by way of providing jobs and will not be held responsible for any injury.
Todays Date
  
  

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This site was last updated 06/23/09