All fields marked with an * asterisk are required.

    First Name*

    Last Name*

    Email*

    Age*

    Address

    Home Phone

    Gender:
    MaleFemale

    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.

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