Youth Programs Inquiry Form

**First Name	**Last Name
Home Phone	**Mobile
Email (**Email or Phone required in order to submit form)	Preferred Method of Contact:
**City	**Date of Birth:
Attending CRLS:(Check if True)	If not CRLS, current school:
**Current Grade:	Expected Year of Graduation:
Eligible for free or reduced lunch:(Check if True)	Currently employed:(Check if True)
How did you hear about us?:	Additional Information: (like work availability & interest)