2016-2017 Fresh Futures Youth Program Application-New Students
We are so glad that you want to be a part of the Fresh Futures Youth Program. Below is the application for new students. There are 3 parts to the application that must be completed to be considered for the program.

1. Simply complete the online application below.
2. Submit proof that you are in high school in ONE of the following ways to fmfreshfutures@gmail.com
- Scan/email a school ID
- Scan/email a grade portal print out or screen shot from this school year
- Scan/email a progress report from this school year
- Have an email sent on your behalf from your school
-Take a picture of your school ID then email it to us
-Come to our office to use computers in the direct connect office upstairs
3. Sign the program waiver/additional documents. Once you complete steps 1 and 2 we will send a follow up email detailing how you can complete this step/what documents you need to complete

Remember, as long as you complete steps 1 and 2 you reserve a spot in the program. Completing step 3 solidifies your spot in the program.

If you have any questions, contact us at 904.854.6770 option 1

We looking forward to an exciting year in Fresh Futures with you!

Good Luck!

NEW STUDENT INFORMATION
Tell us a little bit about yourself.
Student Last Name
Your answer
Student First Name
Your answer
Street Address
Your answer
Apt/Unit Number
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Student Home Phone
Your answer
Student Cell Phone
Your answer
Student Email
Your answer
Student Age
Your answer
Gender
Required
Race/Ethinicity
Required
Student Date of Birth
MM
/
DD
/
YYYY
Do you have any allergies or medical conditions we should know about? If yes, list them below.
Your answer
What size T-shirt do you wear? (Select a size)
Do you recieve free or reduced price lunch?
Have you ever been involved with the criminal justice system?
Do you have access to transportation to attend sessions or summer internship site (if eligible)
Next
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