Registration

REGISTRATION and SUBMISSION DEADLINE: March 1, 2013

By registering your youth group in RSA! you are committing to doing a health ACTion-project which includes: assessing your community, researching best solutions to a health problem, implementing a solution and documenting the whole process on video. Youth groups have up to one year to complete their action-project. Make sure to sign up for the email list and create a blog on the site to stay informed and in the conversation.

The deadline for submitting your health action-project and video is March 1, 2013.

Being a part of this youth driven initiative gives you access to:

Resources on health, youth leadership and technical assistance with making a video.
A connection to other youth leadership groups who are also working on community change around health.
A blog page for your group.
A camera to document your process, if you need one.
A showcase event in spring of 2013 to view your work and the work of youth leadership groups across the state.
An opportunity to receive a contribution of up to $5000 for your group.

Please fill out the form below.

Be sure to review the ACTion Steps page for the steps to this project and the judging and submission criteria.

Name of youth group
One Line Project Description
Please enter a one line project description - this may be simply the name of your group and the focus of your action-project.
Group’s general purpose/mission
This should be a one paragraph description of your action-project. This will be displayed on your team's action-project page.
Who or what organization sponsors the group (e,g, provides an adult facilitator, space)?
Contact telephone number/cell phone number (please distinguish)
Email - for the youth contact. This email will be used for all communications and for your Ready! Set! ACTion! website access. Make sure it is one you check!
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Is your group a registered 501(c)3 organization? Please pick one.
- Yes
- No
If not, is your group sponsored by or partnered with a 501(c) 3 organization(s) that might work with you on this project?
Contact name of youth group adult advisor
FirstLast
Youth contact
FirstLast
Website
If your team has an external project website, enter it here. However, this is not a required field.
How many active youth members are in the group?
How many adults?
What health topics are your groups interested in? List as many as you would like.
Why do you think challenging youth leadership groups across the state to identify and do something about a health issue is important?
Team Picture
Please upload a picture of your team. If you don't have a picture to upload now, we can update this later. (Please limit picture to 180px wide and 3mb in size)
In order to produce a health-action video of your group’s work and project, you will need a camera and editing software. Of these items, which ones do you need to document your work?
- Camera
- Editing software (there are free resources on the internet that we can help you connect to)
Captcha
Once we receive your registration form, we will contact you to follow up on equipment needs as well as discuss any other questions you have about getting started.
Twitter Page
Please enter your Twitter team page URL. If you don't have this now, this can be entered later.
YouTube Video Link
Please enter a specific url link to a team video. This will be the specific video that we have to play on your action-project webpage.
Registration Complete
Enter YES when ACTion-Project Page is setup.
Facebook
Enter your ACTion-Project Team Facebook page. This can be updated at a later time.

Ready! Set! ACTion!

Registration