L.E.A.P. Interest Form 
The Life Enhancement and Advancement Program (L.E.A.P) is an atypical (intensive) social services program that utilizes a Cradle to Grave model to help youth achieve success. It begins with self-awareness and ends with stability that is sustained through actual proactive participation in the development and execution of each participant's life plan.  

This program is open for youth ages 16 to 24 in Palm Beach County, Florida. All information submitted by this form is confidential and only used to evaluate eligibility for the program.

Contact info@advocacyactivists.org if you have any questions.
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Email *
I am in need of the following services: *
Select all that apply.
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First Name *
Last Name *
Date of Birth (Day/Month/Year - example 02/21/2001)  *
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Phone number *
Address *
City *
Zip Code *
Social Media Handle @accountname (include which platform IG, X, Facebook or TikTok) *
Have you been to Foster Care? *
How did you learn about this program? *
Required
Please print your name: (This will be used as your signature) *
Today's Date *
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A copy of your responses will be emailed to the address you provided.
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