Apply for Programs

Name: *

First Name

Last Name

Phone: *

(###)

###

####

Preferred Contact Method: *

Phone

Email

Text

Current Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you applying for yourself or on behalf of someone else? *

Myself

My child

Someone else

Which of our programs are you interested in? (Select all that apply) *

Career Mentorship

Community Events

Workshops

Other

Are you currently receiving support from any other organizations or services?

Yes

No

Do you currently attend school or college? *

Yes

No

Are you the first in your family to attend college or pursue higher education?

Yes

No

Have you experienced any of the following challenges in the past 2 years? (Select all that apply) *

Housing insecurity or homelessness

Loss of a parent/guardian or caregiver

Foster care involvement

Community violence or trauma

Mental health struggles

Academic difficulties

Financial hardship

Other:

Are you under the age of 18? *

Yes

No

Do you consent to NorthStar contacting you to follow up and match you with services? *

Yes

No