Thank you for your interest in Cascade AIDS Project’s Youth HIV Prevention Education Program, CHATpdx! This nationally recognized program is a great way to gain leadership skills, meet new people, and make difference in your community.

To learn more about this program, go here: https://www.facebook.com/CHATpdx

All individuals 24 and under who are able to get to a weekly meeting in Portland are invited to apply!

To get the process of becoming a CHATpdx Peer Educator started, please take some time to answer the following questions. Your answers will help us get to know you better.

Question Title

* 1. Name you go by:

Question Title

* 2. Phone number:

Question Title

* 3. Email address:

Question Title

* 4. School you go to (if applicable):

Question Title

* 5. Mailing address:

Question Title

* 6. Facebook page (if applicable):

Question Title

* 7. Will you want school credit/volunteer hours/other?

Question Title

* 8. Can we leave you a voicemail?

Question Title

* 9. If we do, can we say we’re calling from Cascade Aids Project? YES / NO

Question Title

* 10. Can we contact you via Text Message?

Question Title

* 11. What is the best time of day to contact you? Choose any that apply

Question Title

* 12. How old are you and when is your birthday?

Question Title

* 13. Have you heard of CHATpdx or the Cascade Aids Project before? If so, how?

T