Course Enrollment

The Young People Aspire Higher (YPAH) presents the virtual course entitled
'Young Black Leaders'.

Click on the document below for
- Course schedule

* Indicates required field

Child's Name *

First

Last

School *

I have paid for the following course *

11-13 Yrs (Wednesday's @ 5.00 PM) 11-13 Yrs (Thursday's @ 5.30 PM) 13-16 Yrs (Wednesday's @ 6.00 PM) 13-16 Yrs (Thursday's @ 6.30 PM)

Age of child *

Address of named child *

Line 1

Line 2

City

State

Zip Code

Country

Email of parent / carer *

Parent / carer phone number *

Level of English for their age *

Average Above average Below average

Is the named child available for the other session? *

Yes No

Does the named child have any allergies / additional needs / requirements? *

Parental consent *

I give permission for the named child to enrol on the Young Black Leaders Course

I agree to receiving marketing and promotional materials .

I agree to receiving marketing and promotional materials *

Submit