SpeakUp! Event Registration

Please complete the form below to register for an upcoming SpeakUp! event:
Participant Info
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Speakup Staff
You can select from contacts that have been previously assigned to a Facilitator, Staff, or Volunteer Group in CiviCRM
Choose Prior
Select the SpeakUp! Event you're registering for:*
Name*
.
First Last
Address*
Street Address City State Zip Code
Email*
Phone*
Phone number will be used if additional support is needed during or after the event.
Which gender pronouns do you identify with?*
Are you on the Student Leadership Team for this event?*
Participant Type*
School Staff Type*
Which school are you associated with?*
Student's grade*
Student's High School Graduation Year*
Grade to Graduation Year Chart
6th: 2031
7th: 2030
8th: 2029
9th: 2028
10th: 2027
11th: 2026
12th: 2025
Breakout Session
You will be participating in ONE Breakout Session. Please Rank your top Breakout choices in order of preference: (1-3)
Topics (click here to view topic talking points)
Discrimination
- Have you ever felt that someone was discriminatory?
- How did that make you feel?
- What do you think people may and may not understand about discrimination?
- How do you deal with discrimination?
- Have you ever felt like you were being discriminated against?
- How do you talk about facing discrimination with parents?
- Finding people you can relate to
- Taking action
- Academic (heritage)
- Support system/Strategies
Academics (College, Grades, Classes, Etc.)
- How do you manage stress? Do you feel stress?
- Parental/Teacher/Self expectations
- Comparison to others
- Worth pertaining to academics / The idea of failing
- Have you ever needed validation from academics?
- Do you think your parents might not understand your stress?
- What scares you about academics?
- Overload/Overthinking/The Future
- Self-deprecation
- Do you think the competitiveness at EA is hurtful or helpful?
- How is your time management?
- Preconceived concepts about race/ethnicity relating to academics?
Expectations
- Parental/Family
- Friends/Social
- Comparison
- Self-expectations
- Goals
- What do healthy/realistic expectations look like?
- How can expectations ruin self-confidence?
- School expectations
- Allowing room to make mistakes
- Fear of failure
- Social media
- How can you manage failure?
- Wanting to change what has already happened
- Societal/School pressures
Mental Health
- Past experiences with mental health
- How do you deal with certain moods?
- Stigma, Judgment, Negative self-talk
- Schoolwork
- Finding coping solutions
- Taking mental health more seriously
- Awareness / Unseen disabilities
- Positive vs. Negative
- Teaching parents
- Managing emotions
- Finding coping solutions
- Outside impacts
- Sleep/Lack of sleep
- Treating others how you want to be treated
Topics: 1st Choice*
Topics: 2nd Choice*
Topics: 3rd Choice*
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Topic/Room Selection
Note: Please be sure you have selected 3 different Topics.
*We will do our best to give you your first choice topic, but it is not a guarantee.*
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Contact Preference
- Click here to opt-out of Speakup! emails which include valuable resources, Parenting Adult Coffee Invitations, School Adult Discussion Invitations, Youth Mental Health First Aid Training Opportunities and much more.
Will other family members be attending this SpeakUp! event?
Family Members Attending
NOTE:THIS DOES NOT REGISTER THAT FAMILY MEMBER. All Participants must register separately. Listing family members below ensures you will not be in the same breakout with those listed.
Attending Family*
First name Middle initial Last name This person is my
e.g. Parent's name is John Smith and email is [email protected], and student's name is also John Smith with an email address of [email protected]
- My name and email address are the same as my child or parent.
e.g. Parent's name is John Smith and email is [email protected], and student's name is also John Smith with an email address of [email protected]
Name
This field is for validation purposes and should be left unchanged.

First name	Middle initial	Last name	This person is my

Participant Info

Breakout Session

Topics (click here to view topic talking points)

Discrimination

Academics (College, Grades, Classes, Etc.)

Expectations

Mental Health

Family Members Attending

Special thanks to our Corporate Partners

SpeakUp!