Program Registration Form
Thank you for your interest in The Troubled Movement, Inc. and our programs. Please fill out the following information. If you are a parent registering a child, please use their information. If you have any questions, feel free to email
. Let's get started!
What program are you interested in?
For detailed information on our programs, visit
Movement Mentoring Program (men & women ages 13-25)
Marvelous Men Moving Forward (men ages 13-25)
Young Women of Power (women ages 13-25)
Heroes & Survivors (victims of abuse or mental illness; any gender; any age)
Project Excellence (men & women ages 13-25)
How did you hear about us?
The Troubled Movement Website
Emergency Contact or Parent Information
Please provide the full name and phone number of your emergency contact or parent.
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