2024 Traditional Tobacco Teachings Registration Form

Tribal Youth Ambassadors for Tobacco Control

In collaboration with The Cultural Conservancy, the Tribal Youth Ambassadors for Tobacco Control Project will host an interactive, hands-on, traditional tobacco teachings workshop to demonstrate how to plant traditional tobacco.

The workshop is for Native community members from/residing in Sonoma, Lake, and Mendocino Counties.

Once you complete this pre-registration form, you will receive an email within 2-5 business days that notifies you as to whether or not there is room left in the workshop. If the registrations are full, you will also automatically be added to the waitlist for the class and receive a notification about your waitlist status.

Question Title

* 1. Contact Information:

Name

Tribal Affiliation

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

County

Email Address

Phone Number

Question Title

* 2. Age

Under 18

18-24

25-34

35-44

45-54

55-64

65+

2024 Traditional Tobacco Teachings Registration Form

Tribal Youth Ambassadors for Tobacco Control

Question Title

* 1. Contact Information:

Question Title

* 2. Age

Question Title

* 3. Please share with us why you would like to take this workshop: