Empowering Voices Registration

Thank you for registering for Close Up’s Broward Middle School Civic Action Program. Once you complete the form below, you will receive an email with more information about student registration and how to access your on-demand PD.

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

City State ZIP / Postal Code School Name

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