All fields marked with an * asterisk are required.

First Name*

Last Name*




Home Phone



What school do you attend?

Agreement: Please accept our agreement*
By submitting this application, I agree to participate in The Teens With a Purpose program run in partnership with the organizations mentioned below. I understand that I will participate in pre-planned meetings/practices, open-mics, educational forums, community events and social events at TWP offices, partner organizations locations and at off-site locations. I understand that the nature and purpose of any photographs taken will be in regards to "Teens With a Purpose" and not any other program. I understand that the people who serve as guides in our program are adult staff members who have been carefully screened by the organization. I understand that there may be instances whereby staff/volunteers may be driving me to assorted events or supervising my participation in various activities.