Empowering Voices Registration

Thank you for registering for Close Up’s IMPACT: Justice and Equity Program scheduled for 7/19-7/23 from 12:00pm-4:00pm (EST) / 3:00 pm-7:00 pm (PST). Once you complete the form below, you will receive an email with more information about student registration process.

Name*
Email School Name
Mobile Phone Number
How did you hear about us?*
Address*
Street Address

City State ZIP / Postal Code School Name
Number of Students:*

Select Payment Type:*

Initial here to indicate that you have read and agree to the Terms and Conditions: