Ask Us for Help
Our website does not currently have the ability to submit this form online and will require additional steps.
Please bare with us as we work on including more services in our website.
Apply now for a chance to be in our program!
Download or Print the PDF of our application!
* Know that, you must answer all questions about yourself only. All questions must be answered in order for us to fulfill your dreams. This form must be returned by November 1. Failure to return this form by deadline could result in you not being accepted by our program.
For all parents, if your teenager has been accepted into our program, it is crucial that you do not receive assistance from another program. Doing so will be found as doubling up these charity programs and will result in declinations from all charities.