Youth Workshop Questionnaire

This form is used so we can know more about who you are and how you describe yourself. Art from Ashes will keep your personal information confidential, and will not share it without permission from you or your legal guardian. If you give us your info, we may contact you (with your permission) to inform you of upcoming events we think may interest you. Thank you!

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Today's Date

Name *

First

Last

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Email *

If we want to reach you, can we email you? Of course! Just not A LOT! No way

Phone *

Date of Birth (Optional)

How old are you? *

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How do you identify?

• Girl/Female
• Boy/Male
• Non-binary

What is your pronoun?

• He/him
• She/her
• They/them
• Other

Do you identify as LGBTQIA?

• Yes
• No
• Prefer not to answer

Which best describes you? *

• Black or African American
• Asian or Pacific Islander
• Bi-racial or Multi-racial
• White or Caucasian
• Latinx or Hispanic
• Native American, Eskimo or Aleut
• Other

If Other, please fill this out

Your Home County *

Where ya live

• Adams
• Arapahoe
• Boulder
• Broomfield
• Denver
• Douglas
• Jefferson
• Other County
• Outside Of Colorado

If outside of Colorado, please let us know your state

If Other County in Colorado, please let us know your county

Zip Code

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Where are you taking this workshop? *

• Art from Ashes Virtual Wednesday
• ACEConnect
• Anythink Libraries
• Boys and Girls Club
• Century Middle School
• Denver Online High School
• Gilliam Youth Services Center

Check whichever is true for you: *

• I am in elementary, middle or high school
• I have graduated high school
• I have my GED
• I am in college or vocational training
• I stopped college or vocational training before graduating
• I graduated from college or vocational training
• None
• Other

If Other, please list below

If you're in elementary, middle or high school, what grade are you in?

School Lunch ID number (Denver Public Schools Students only)

Which social media do you use?

• Facebook
• Twitter
• Instagram
• Google Hangouts
• TikTok
• Youtube
• Other

Any other things you would like to share...

Submit