Tell us about yourself. Please share your name, contact information (phone and email), and anything else you’d like us to know about who you are. 

What motivates you to join the Concrete Rose Foundation? We’d love to hear about what inspired you to connect with us and what you’re hoping to achieve through this program.

How would you describe your current situation?

What kind of future are you working toward? Imagine your ideal life—what does it look like? What kind of work, relationships, or personal accomplishments would make you feel fulfilled?

How do you currently spend your time? Are you employed, caring for others, pursuing education, or focused on other activities? We’d like to understand how your day-to-day life 

What skills or experiences are you most proud of? These could be work-related, personal achievements, or ways you’ve supported others.

What do you love to do? Whether it’s hobbies, activities, or areas of work that excite you, we’d love to hear about the things that bring you joy.

What do you find most challenging right now? What’s the most stressful part of your life, and what kind of changes would make it easier or less overwhelming?

Have you faced any significant challenges in your life that shaped who you are today? You’re welcome to share anything you feel comfortable discussing. We see challenges as opportunities to repurpose into strengths.

What kind of support do you need most right now?

What are your goals for joining this program? Are there specific things you’d like to learn, change, or achieve through working with us?

Do you have a loved one who is incarcerated or has been? If so, are you currently supporting their dependents or navigating responsibilities related to their situation?

How do you see your past experiences helping shape your future? At Concrete Rose, we focus on repurposing experiences into tools for success. 

What do you feel your past has taught you or prepared you for?

Are you ready to rebuild and repurpose your challenges into strengths? If so, what excites you most about this journey?