B.O.S.S. Application
The Building Out Successful Students Program (B.O.S.S.) is a year-round empowerment program that serves adolescent aged youth (14-18) that are transitioning into adulthood while experiencing life challenges. Those challenges include Schooling, Community and Self Development. 

The objective for B.O.S.S is to provide holistic support for Memphis youth to purposefully pursue high quality lifestyles that will enhance them and their communities. Our mission is to create an environment in which young people are empowered, valued, guided and taught leadership skills, which contribute directly to their self-confidence and personal growth. 

Please know that this form provides automatic access of being put on the waitlist.
Thank you in advance for taking the time to complete this application!
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What is your First and Last name? *
What is the best contact number for you? *
What is the best email address to contact you? *
What is the student's First and Last name? *
How old is the student?  *
What is the student's grade level? *
What school does the student attend? *
Does the student have a state ID? *
Are you the student's primary caregiver?   *
What is your relationship to the student? (Mother, Father, Grandparent, etc.) *
Will there be any issues with getting the student to and from the weekly sessions? (If so, please explain in "other") *
Do you have any special concerns about the student? (Socially, mentally, academically, medically, etc? *
Please select your preferred site days.  *
Which location/site do you prefer for placement?
 *
Required
Which location where you recruited at? 
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