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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 Name *
Parent/Guardian Email *
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:
What are you interested in doing with Sail2Change? Please check all that apply: *
Required
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