Trellis For Tomorrow Program Application NOTE: Due to uncertainties surrounding COVID-19, Trellis for Tomorrow reserves the right to cancel programming at any time, which would include ceasing participant pay. Location Spring CityPhoenixvillePottstownPottsgrove Have you participated in the program you are applying to before? NoYes If "Yes", how many times?" Youth Participant Information (all fields required) Last name First name Street address City State Zip Home phone Student's cell phone Student's email Current school Graduation year Best time to reach you Best way to reach you CellEmailHome phone Gender MaleFemaleOther Current age Birthdate Race African-AmericanAsianHispanicOtherWhite Parent/Guardian Information (all fields required) Parent/Guardian MotherFatherGrandparentAunt/UncleOther Last name First name Home phone Cell phone Email Best time to reach you Best way to reach you CellEmailHome phone PLEASE PROVIDE HOUSEHOLD & INCOME INFORMATION: THIS INFORMATION IS FOR STATISTICAL PURPOSES ONLY. Trellis relies heavily on funding to be able to offer these programs, as well as offer participants an educational grant. Our funders occasionally ask for statistics, household size and income in particular, and providing them with this data helps us continue to receive their grants. We DO NOT share any personal information (i.e. no names), only the statistics of family size and income. We greatly appreciate your cooperation in providing this information. TOTAL NUMBER of PEOPLE in the HOUSEHOLD (you plus everyone else) ESTIMATED TOTAL ANNUAL HOUSEHOLD INCOME: Send
