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Inspyer Participant Interest Form

Thank you for your interest in Inspyer. This form will help us learn more about you, your goals, and the type of support you may be seeking. Completing this form does not guarantee program acceptance.

Inspyer’s current participant programming is intended for individuals ages 18–24. If you are under age 18, please do not submit this form. A parent or legal guardian may contact Inspyer to request information about future programming or available community resources.

Are you currently 18 years of age or older? *

Yes

Contact Information

Full Name *

Preferred Name

Pronouns (Optional)

Date of birth *

Age *

Email Address *

Phone *

Preferred Method of Contact *

Phone

Text

City

State

Postal Code

How did you hear about Inspyer? *

Choose one or more options

Are you currently: (Check all that apply) *

Attending High School

Attending College/Training Program

Employed Full Time

Employed Part Time

Seeking Employment

None of the Above

Interests and Goals

What interests you most about participating in Inspyer? *

Which areas would you like support with? (Check all that apply) *

Community Outreach

Event Setup and Support

Program Assistance

Administration Support

Fundraising

Social Media and Communications

Photography/Videography

Marketing/Graphic Design

Workshop Facilitation

Financial Literacy Education

Workforce Readiness Support

Housing/Homeownership Education

Donation Drives

Food/Clothing Distribution

Youth and Young Adult Activities

What are three goals you would like to accomplish over the next year? *

Goal 1
Goal 2
Goal 3

What challenges, if any, are making it difficult for you to reach your goals?

What would you like to gain from working with a mentor or paticipating in Inspyers programs?

Availability

How often are you available? (Check all that apply) *

One-Time Event

Occasionally

Monthly

Twice Per Month

Weekly

As Needed

What days are you generally available? (Check all that apply) *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time are you available? (Check all that apply)

Morning 9AM-12PM

Afternoon 12PM-3PM

Late Afternoon 3PM-6 PM

Evening 6PM-9PM

Do you Prefer: *

In-person

Virtual

No Preference

Do you have reliable transportation? *

Yes

Emergency Contact

Emergency Contact Name *

Emergency Contact Relationship *

Choose one or more options

Age Eligibility Certification *

I certify that I am at least 18 years of age and that I am completing this form on my own behalf.

Acknowledgment *

I understand that submitting this form is an expression of interest and does not create a formal partnership or agreement. An Inspyer representative will contact me to discuss potential opportunities and next steps.

Electronic Signature

Clear

Today's Date *