RYSE Center Login System
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Username:
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Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.
E-mail address:
*
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Password:
*
Confirm password:
*
Provide a password for the new account in both fields.
First Name:
*
Last Name:
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About
Birthday:
*
Month:
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Jan
Feb
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Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day:
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Year:
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1922
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2011
2012
Address
Street:
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Additional:
City:
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State/Province:
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Postal code:
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Phone number:
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Race / Ethnicity:
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Black/African American
Latino/Chicano
Asian/API/Southeast Asian
South Asian
Arab/SWANA
White/European American
Native American/American Indian/Indigenous American
Mixed Race
Languages:
*
American Sign Language
Arabic
Burmese
Cantonese
Chinese
Dutch
English
Farsi
French
Haaka
Hawaiian
Hebrew
Hindi
Ilokano
Indonesian
Italian
Japanese
Javanese
Kachi
Kannada
Khmer
Korean
Laotian
Malay
Mandarin
Mien
Mieu
Navajo
Nepali
Polish
Portuguese
Punjabi
Russian
Samoan
Spanish
Tagalog
Tamil
Telugo
Thai
Toi-san
Toishenese
Urdu
Vietnamese
Visayan
What languages do you speak? Hold down the CTRL key (or 'command' on a Mac) to select more than one.
Gender:
*
Questioning
Male
Female
Transgender
Sexual Orientation:
Straight
Gay
Lesbian
Bisexual
Queer
MediCal:
*
Yes
No
Don't know
Are you eligible for MediCal?
School Lunch:
*
Free Lunch
Discounted Lunch
No
Are you eligible for free lunches at school?
Emergency Contact
Emergency Contact:
*
Please provide name, relationship to you, and relevant contact information.
RYSE
How did you find out about RYSE?:
*
Friend
Flyer
School
RYSE Team or Staff
Another organization
Myspace
Facebook
Other
Which programs are you interested in?:
DJing
Music production (making beats, singing and vocal lessons, recording)
Dance
Yoga and meditation
Fitness
Nutrition
Tutoring/Study Hall
One-on-one tutoring
Classes to learn about your history and other people’s histories and cultures
Help with school applications
Help with job applications
Help with finding a job
Help with reading skills
Help with writing skills
Becoming a youth leader
Planning center and community-wide events
Creative writing
Support groups (young women’s groups, young men’s groups, LGBTQQI, NA, AA)
Health Services
Family planning and parenting classes
Art (drawing, painting, animation, graphic design)
Education
School:
*
Yes
No
Are you currently attending school?
School Type:
- None -
Middle School
High School
College (2 year)
College (4 year)
Internship / Apprenticeship / Job Training
School Name:
CAHSEE:
- None -
Passed
Not Passed
Have you passed CAHSEE?
GED:
- None -
Have earned my GED
Am seeking my GED
Not interested
RYSE House Rules
I've read the
RYSE House Rules
and I agree to respect them.
*
