Native Youth Virtual Gathering Conference Application Held July 24th-26th, 2020, participants will virtually learn from Native leaders across the state of California to learn about the importance of the 2020 Census and work with an artist of their choice over the three-day conference to create an art piece that expresses the importance of California Native Americans participating and being counted in the 2020 Census. Driven by Los Angeles-based NPCCA Native Youth Initiative Coordinator Jeri Brunoe participants will engage for three hours each day over the three days to create a conversation with one-another throughout the state to bring home to their families and their communities to ensure we get a Native Complete Count this 2020 Census! Step 1 of 4 25% Registration InformationYouth Attendee Name (First & Last)*Age*Tribal Affiliation*Email* Daytime Phone*Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Participation InformationDo you have access to video chatting via internet?*Select OneYesNoShirt Size (Unisex Sizes)* Small Medium Large XL XXL XXXL 4XL Rate Your Class SessionsRate your class choice from 1-First Choice 2- Second Choice 3-Last Choice. You will be placed in a class of your choice based on availability.Storytelling*1 - First Choice2 - Second Choice3 - Third ChoiceMovement/Contemporary Dance*1 - First Choice2 - Second Choice3 - Third ChoiceMuralist*1 - First Choice2 - Second Choice3 - Third ChoiceCultural Art*1 - First Choice2 - Second Choice3 - Third ChoiceBasketry*1 - First Choice2 - Second Choice3 - Third ChoiceSketch/Cartoonist*1 - First Choice2 - Second Choice3 - Third ChoicePhotography*1 - First Choice2 - Second Choice3 - Third ChoicePoetry/Spoken Word*1 - First Choice2 - Second Choice3 - Third ChoicePoetry/Spoken Word*1 - First Choice2 - Second Choice3 - Third ChoiceTheatre*1 - First Choice2 - Second Choice3 - Third ChoiceCultural Jewelry Making*1 - First Choice2 - Second Choice3 - Third Choice PermissionsName of Participant* First Last Participant Commitment Statement* I hereby agree to actively participate in the 2020 NPCCA Virtual Youth Gathering. I will be on time to and respectful at all organizers, presenters and participants. I will abide by all appropriate internet etiquette guidelines. Date* Date Format: MM slash DD slash YYYY Legal Guardian PermissionName of Legal Gaurdian* First Last Legal Guardian Phone Number*Legal Guardian Permission Statement* As the legal guardian, I hereby approve the participation of my child in the 2020 NPCCA Virtual Native Youth Gathering. I will not hold liable Native People Count California, or any of its agents, volunteers or other organizations involved in the gathering. By checking the box below I grant permission to photograph and/or film for use by NPCCA. Date* Date Format: MM slash DD slash YYYY Once your application is received, you will receive an email confirming your participation. If you have any questions, please email mailto:[email protected]
