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NextGen Roundtable: Bay Area Youth Summit Student Enrollment Form
Please complete the form below to enroll and participate in
NextGen Roundtable: Bay Area Youth Summit
with your school, taking place November 3, 2026, at Stanford University. Through respectful dialogue, we aim to return the “civil” to public discourse. If you are under 18 years of age, this form must be completed with a parent or legal guardian.
Student Name
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Last
Phone
Personal Student Email
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Date of Birth
Parent/Guardian Name
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Last
Parent/Guardian Email
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Parent/Guardian Cell Phone
School Name
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Student School Email
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Teacher's Name
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Teacher's Email
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Grade Level
Grade 9
Grade 10
Grade 11
Grade 12
Which, if any, of the following civics-related clubs or activities do you participate in?
Choose One
Model UN
Model Congress
Mock Trial
Debate
Community Service Clubs
Peer Mediation
Student Government
Key Club
AP Government
AP Seminar
Service Learning in class
Other
None
What motivated you to participate in A Day of Deliberative Dialogue?
Promoted by a club/class
Requirement of a club/class
Interested in learning deliberative skills
Other
Other
Demographic Questions
For educational and funding reporting purposes, Close Up requests that you provide the following demographic information. Such information will remain confidential and will not be used at any time for selection or placement criteria for the Close Up programs. Please complete all items below. Your cooperation is greatly appreciated.
Are you a member of a farm/migrant community?
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No
Which best describes your school district?
Choose One
Urban (city)
Surburan (outside city)
Rural (country)
Which best describes you? (please select one or more)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino/a
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Some Other Race
Is the participant 18 years of age or older at the time of signing this agreement?
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Student Terms and Conditions
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