Dayton, OH WHB Super Weekend Registration & Payment Form

$20 To attend all 5 events over 2 days!

1. Friday 6-9pm Araminta Harriet Tubman -The Warrior-Healer-Builder Story Presentation.

2. Certification Awards Ceremony 9am

3. African Centered Education - Topics: Sankofa Math for Mastery & The Family-Lore project for History and Literature like you've never seen it before.

4. Taste of Warriors-Healers-Builders- a 4-Hour Communication Conflict Resolution Workshop for Families, Organizations and Businesses 1-5 pm Sat.

5. Brothers and Sisters Discussion 7pm-9pm Feature: Separate and Together groups. Topics- The Movie Fences plus Overcoming Oppression and Family Barriers to produce Warriors Healers and Builders 7pm-9pm

Sponsor:
•West Dayton Youth Task Force
•Racial Justice NOW!
•Body of Christ Deliverance Center

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I'm Registering For: (Choose all that apply)

I'm Registering For: (Choose all that apply) Dayton, OH (May 5-6, 2017) One Ticket @ 20.00 Two Tickets @ 40.00 Three Tickets @ 60.00 Four Tickets @ 80.00 Five Tickets @100.00 Six Tickets @120.00 Seven Tickets @140.00 Eight Tickets @160.00 Nine Tickets @180.00 Supporter - Ten Tickets @200.00 Sponsor: Twenty Tickets @ 400.00 Other - Contact hajabar.com Other - Contact hajabar.com

Choose all that you want to and plan to attend.
I'm Registering now, but will pay later. (Call (937) 319-1671)
-- Your seat is will not be held until you've completed your registration by paying.

I'm Registering now, but will pay later. (Call (937) 319-1671)
-- Your seat is will not be held until you've completed your registration by paying. Araminta WHB Fri. 7-9:30pm Araminta- TWHBS Certification Intro 9am African Centered Ed / WHB Intro WHB Taste 1-5 pm Sat. Brothers / Sisters Discussion 7pm Sat Other Other

Choose all that you want to and plan to attend.
What interests you most about AYA's WHB Program or how have you benefited so far?
I would like to stay connected with AYA Educational Institute. Please sign me up for AYA's

I would like to stay connected with AYA Educational Institute. Please sign me up for AYA's Email list TXT 180 Texting Program Invite me on Facebook (FB)
Would you be willing to invite others to these WHB opportunities?

Would you be willing to invite others to these WHB opportunities? Yes No Other Other
Scholarship Section

Please use this section to apply for scholarships. Thank you for asking.
Scholarship For WHB Super Weekend. Brothers and Sisters Session. Please explain how much help you need and a brief statement explaining why you want to attend.

Dayton, OH WHB Super Weekend Registration & Payment Form

Dayton, OH WHB Super Weekend Registration & Payment Form

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Scholarship Section

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