WE ARE SOCIAL CHANGE

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Martha Wilkerson
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1 Young Women for Change Oakland County Chapter Presents WHO AM I? Preparing To Serve: Mentally, Physically and Emotionally One-day free conference for female high school students interested in social change WE ARE SOCIAL CHANGE October 4, :00 a.m. 4:00 p.m. Torch of Wisdom Plaza West 9 Mile Road Southfield, MI Enrollment Form Attached Limited Enrollment Information/FAX: Funded By Detroit Public Library Foundation Filmer Family Trust

interested in social change WE ARE SOCIAL CHANGE October 4, 2014 9:00 a.m.

2 Young Women for Change Oakland County Chapter Preparing To Serve: Mentally, Physically and Emotionally One-day free conference for female high school students interested in social change NAME: ADDRESS: CITY/ZIP: STUDENT PHONE NUMBER: STUDENT PARENT/GUARDIAN: PARENT PARENT PHONE NUMBER: HIGH SCHOOL: Grade September 2014: ADDRESS:, MI ( ) I am interested in the October 4, 2014, Conference ( ) I am interested in joining Young Women for Change Oakland County Chapter LIMITED SPACE REVIEWS BASED ON ORDER OF RECEIPT Towywfc@yahoo.com FAX: PERMISSION My daughter,, has my permission to attend the October 4, 2014, YWFC Conference. I understand the conference will be held at the Torch of Wisdom Plaza in Southfield, MI. A continental breakfast and full lunch will be served. I understand no transportation will be provided. Parent/Guardian Signature Date

Conference ( ) I am interested in joining Young Women for Change Oakland County Chapter LIMITED SPACE REVIEWS BASED ON ORDER OF RECEIPT EMAIL: Towywfc@yahoo.com FAX: 313.862.

3 PERMISSION TO ATTEND A XPOSURE SESSION Xposure, Inc. requires all participants under the age of 18 to submit written permission from their parent or legal guardian prior to attending an education workshop. The Healthy Relationship Workshop is sponsored by The Torch of Wisdom Foundation, Inc. and will be presented on October 4, Content topics for discussion may include, depending on participants inquiries: Healthy Relationships Anatomy Sexuality STD s Understanding HIV and STD s Contraception Abstinence and Negotiation Skills Xposure, Inc. exercises strict confidentiality as it pertains to comment and questions discussed throughout sessions. While written permission is required for participants under the age of 18 to attend a Xposure, Inc. session, such documentation does not grant parental access to confidential program commentary. If you have questions about the content of the workshop please contact Christina (248) or xposure.incorporated@gmail.com. Please complete and sign in the fields below to convey approval and to grant your child access to the upcoming workshop. To find out more about Xposure, Inc., please go to: I have carefully read this permission slip and understand its content. I, parent/legal guardian, herein grant my child, permission to participate in the Healthy Relationship Workshop and like activities presented at the October 4, 2014, Who Am I conference. Date: Parent/Guardian Signature: Parent/Guardian Name: (Please Print) This form must be returned with Conference Enrollment Form Sexuality Education, Training & Consulting (248)

The Healthy Relationship Workshop is sponsored by The Torch of Wisdom Foundation, Inc. and will be presented on October 4, 2014.

4 Who Am I? We Are Social Change! Researchers have identified the top ten health issues teens encounter: abuse, sexual relationships, self esteem/image, mental health and depression, teen pregnancy, alcohol and drugs, academic pressure, performance anxiety, inconsistent faith, broken families, fatherless communities, bullying, Internet safety and obesity. Our upcoming conference is based on the need for young ladies to identify personal health issues, to understand health professionals and careers as a means of helping young ladies identify personal issues as well as helping them become advocates for social change. The October 4 th Who Am I conference focuses on female high school students. There are multiple purposes: Assist young ladies in examining themselves mentally, physically, and emotionally Highlight health professionals who can assist them in their selfexamination Focus on health careers as a mode of social service leading to social change Identify personal health mental, physical, and emotional as a base for helping others and advocating for social change Provide a vehicle for reactivating the Oakland County Chapter of Young Women for Change

pressure, performance anxiety, inconsistent faith, broken families, fatherless communities, bullying, Internet safety and obesity.

5 Hawa A. Hoff B.S. Nursing M.S. Nursing - Registered Nurse Family Nurse Practitioner Doctor of Nursing Practice Dr. Melissa I. Jackson B.S. Psychology Ph.D. Developmental Psychology Tanya Wynn, MD B.S. in Biology Medical Degree Obstetrics & Gynecology Christina Bolden B.A. Communications M.S. Social Work Sex Education/Sex Therapy Certification Marcia J. Phillips B. S. Social Work M.S. Social Work Certified: Master Clinical Social Worker School Social Worker

A. Communications M.S. Social Work Sex Education/Sex Therapy Certification Marcia J. Phillips B. S. Social Work M.

Melanie Bierenbaum, Psy.D. Licensed Psychologist 3040 E. Cactus Rd, Suite A Phoenix, AZ 85032 Office: 602-769-2773

Melanie Bierenbaum, Psy.D. Licensed Psychologist 3040 E. Cactus Rd, Suite A Phoenix, AZ 85032 Office: 602-769-2773 Service Agreement and Treatment Consent Welcome and thank you for choosing to work with Dr. Bierenbaum. This document contains important information about professional services, the psychologist-patient