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Sail2Change Application Form
Just a reminder - Our services are targeted towards *high school* students with the greatest need. We serve all genders and individuals of all backgrounds. We provide services to students seeking support for emotional and behavioral complications, low-academic performance, and students experiencing a disconnection from the traditional school environment. Positions in our program are on a first come, first served basis. If you think our programs will be appropriate for your child, please fill out the form below and someone will be in touch with you shortly. Sometimes our emails are forward to people's spam/junk folders, so please be sure to keep a lookout for information that might be lost there. Thank you!
Student Participant Name
First and last name
Student Gender Preference & Pronouns - How do we address you?
Parent/Guardian Phone Number
Best way and time to contact you?
How did you hear about Sail2Change? If it was from school, was it from school staff or Peach Jar?
What grade is the student in?
What school does your student attend?
Please check all that apply. My child:
Has emotional complications
Has behavioral complications
Is frequently truant or absent
Has low academic performance
Tends to experience a disconnection from the traditional school environment
Comes from a low-income family
Qualifies for free or reduced lunch AND/OR our family receives SNAP benefits
Does not know what they want to do for a career or does not have clearly defined interests to lead them in the direction of a fulfilling career
Feels isolated, does not have many friends, supportive family, and/or sense of community
Does not participate in leadership roles
Has low self-esteem
Is a teen parent
Is or has been in the foster care system
Is actively using drugs and/or alcohol
Is clinically depressed or suicidal
Has a history of violence
Has not experienced much of the outdoors or sailing
What are you interested in doing with Sail2Change? Please check all that apply:
Learning to sail
Gaining a mentor
Gaining a tutor
Exploring vocational programs, higher education, and career paths
Monthly educational recreation events
Making new friends and building community
Being a peer mentor
Learn to swim
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