P+C Registration April 2025 ⋆ Citizen University

Name(Required)

First Last

Email(Required)

Phone(Required)

Do you want to get updates about this program by text?(Required)

We may occasionally reach out with info or reminders via text, if that's helpful to you!

Yes

Help us get to know you...

Tell us a little more about your work and why you're excited about the opportunity to pilot this curriculum.

Organization

Title

Your Work with Young People(Required)

At Citizen University we defined "educator" broadly and we think this curriculum can support students in out-of-school time just as much as in the classroom. Tell us more about your role with youth.

What subject(s) do you teach?

What sorts of classes do you teach?

Tell us more about your work with youth

Age Range(Required)

What's the age range of the young people you work with?

High School (age 14-18)

College (age 18-24)

Middle School (age 11-14)

Other

Power + Character = Citizenship

What makes you interested in joining this training? Tell us about civic culture in your community. What do you think your students need most from civic opportunities?

City(Required)

State(Required)

What’s one civic skill, habit, or ritual that you think your community does really well?

What’s one challenge or barrier to active citizenship facing your community?

Pronouns(Required)

We'll add your pronouns your name tag so people know how to refer to you. For example: she/her; they/them; etc. (or prefer not to say).

Race(Required)

For internal tracking purposes, help us know what racial identity (or identities) are important to you (or prefer not to say).

Travel

If you already know how you'll travel to join us for this learning experience, please share that information with us. We have a limited number of travel stipends available, so we encourage you to reach out to Zoey asap if you'd like to request funding to support your participation. [email protected]

Have you booked your flight?(Required)

Yes, I have my flight information

Yes, and I would like to request a travel stipend to supplement my costs

No, and I would like to request a travel stipend to supplement my costs

No, but I will cover my own costs

No, I don't need to fly

Flight numbers (outbound and inbound)

Ex. AS 272 and DL 0426

Dates of travel

Ex. 4/29 and 5/3

Do you need a hotel for your stay?(Required)

We have a block of rooms reserved for this training group, and a limited pool of funding to support lodging costs as needed.

Yes, I would like to book a hotel room for this program

Yes, I would like to book a hotel room supported by a travel stipend

No, I do not need a hotel room

Do you need a hotel for your stay? Select the nights you’ll be staying in town.(Required)

We’ll be staying in the South Lake Union neighborhood of Seattle. If you require an accessible room or have specific needs, please describe below in the “Dietary & Accessibility Needs” section.

Tue, Apr 29

Wed, Apr 30

Thu, May 1

Fri, May 2

I don’t need a hotel room

Emergency contact name(Required)

Emergency contact relation to you(Required)

Emergency contact phone number(Required)

Any other travel-related notes to share?

Dietary and accessibility needs

We strive to host inclusive, accessible experiences that enable all participants to engage fully, including individuals with disabilities, faith or cultural considerations, or any specific access needs. Participation will involve logistics of all kinds — from transportation to/from the airport, hotel, and meeting space; to a full schedule each day; to use of slides and audio-visual media, printed materials; and many things in between. We will do our best to organize the experience responsively with this information in mind.

Do you have any dietary restrictions?

None

Lactose intolerant

Vegetarian

Vegan

Pescatarian

Gluten free

Halal

Kosher

Other: Please explain

Other(Required)

If Halal or Kosher certified foods are not available, how do you typically supplement/replace these foods?

Do you need anything to be comfortable accessing and enjoying this event?

For example, sensory needs, mobility needs, etc. Hint - Now is the time to let us know if you require an accessible hotel room!

Any other questions

Feel free to share your questions with us here, or reach out to Zoey directly — [email protected]

Name

This field is for validation purposes and should be left unchanged.

Power + Character Training Registration Request

Help us get to know you...

Travel

Dietary and accessibility needs

Social Navigation

Site Menu