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    • STEP 1
    REGISTRATION

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    Join us and Enroll

    Welcome to Philly 4 Life. It’s time to get you enrolled so you can become a Philly 4 Life team. Enrollment will take about 10 minutes to complete if you have all of the necessary information listed in the Enrollment Checklist below.

    Philly 4 Life Enrollment Checklist

    From Your Parent/Guardian: (Only if you’re under 18 years of age)

        1. First & Last Name
        2. Cell Phone Number
        3. Email Address
        4. ZIP Code

    From Your Adult Ally (Required for all participants):

        1. First & Last Name
        2. Organization
        3. Cell Phone Number
        4. Email Address

    Let’s start with information about you.

     

    Your Information

    - If you are under 18, you will need to work with your Adult Ally to get your parent’s or guardian’s permission to participate in Philly 4 Life.

    Adult Ally Contact Information

    As you go through this Philly 4 Life experience, you’ll need to be in regular contact with your trusted Adult Ally, who’ll be assisting you through the process. We need to verify their contact information below, so we can ensure that the two of you have connected and are ready to get started.

    (Be sure to select your country code from dropdown menu)

    Sharing What You've Learned on Social Media - Are You Willing?

    Philly 4 Life is asking you to provide us with your Instagram handle so that we can share program updates with you, communicate with you about the peer support groups and connect with others who are down with Philly 4 Life.

    Please choose the appropriate option below...

    In addition to Instagram, we would like you to share your social media handles on any other platforms you use the most, and only under the screen names where you feel comfortable making your posts public.

    Please choose the appropriate option below...

    As part of my lessons and assignments, I will share some of the Philly 4 Life Course information with my family, friends and peers, using this platform and handle (pick all that apply):*

    Philly 4 Life would like to you to share what you learn in the Philly 4 Life Course (Training), specifically using social media platforms. We would also like to acknowledge and highlight Philly 4 Life Graduates as leaders in their communities. One way we can do that is by following and amplifying your public social media posts related to this project.

    We are asking you to post on the social media platforms you use most, and only under the screen names where you feel comfortable making your posts public, so that they go beyond just your immediate peer group. In some platforms, as you know, you can pick specific posts to make public or private; on others, general settings apply.

    We also respect your privacy. If you are being or have been cyber-bullied or harassed or stalked online, you may have chosen to step away from social media for a while. If there is no social media platform where you feel safe sharing information about Philly 4 Life, we understand. Our first priority is your safety.