Heal America Tour
Frederick Douglass Gala
Frederick Douglass Society
Just US Girls
FILL OUT THE FORM BELOW TO ENROLL
How did you hear about Urban Specialists?
Urban Specialists/US Website
Tell us about you...
Select the best entity classification
Law Enforcement Agency
Phone Number (Cell)
Phone Number (Work)
Address Line 2
District of Columbia
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Please choose the best way to describe how you would like to get involved.
I am a passionate individual who would love to volunteer
I am interested in mentoring, providing internships, or eductional opportunities for youth
I have a company/organization and am interested in collaboration or partnership opportunities.
I am not sure, but want to get involved!
Areas of Interest (Check all that apply)
Children & Youth
Crime & Safety
Law & Policy
I agree to the following:
I have submitted certain comments, statements, stories, photographs, video, audio and/or other recordings or media (the “Submissions”) to Urban Specialists (the “Organization”) for the purpose of Power US On. I grant the Organization a perpetual, irrevocable, worldwide, sublicensable, royalty free license to publish, reproduce, distribute, publicly perform, publicly display, edit, modify, create derivative works of and otherwise use the Submissions in any manner or media and for any purpose whatsoever at the sole discretion of the Organization, including without limitation any advertising or commercial use of any kind. I further give my permission to the Organization to use my name, likeness, voice, and biographical information in connection with such Submissions and release the Organization and anyone acting under its authorization from any claims that any use of the Submissions as authorized herein violates any of my rights, including any rights of publicity or privacy. I understand and agree that all rights granted herein are fully sublicensable and assignable.
Save and Continue Later
This iframe contains the logic required to handle Ajax powered Gravity Forms.