Interest Form for the Young Adult Programs at Minnesota Valley Action Council
Thank you for your interest! An MVAC representative in your county will contact you with more information upon completion of this form.
First and Last Name
If you answer "YES" to any of the following items OR are interested in more information, please continue filling out this form and someone will reach out to you shortly regarding which programs you may be eligible for! (Income guidelines may apply for some programs) Check all that apply
I struggle with reading or math
I have a disability, IEP or 504 plan
English is not my first/primary language
I have dropped out of school and/or am attending GED
I am a person of color
I'm homeless, staying with a friend (couch hopping) and/or I have run away from home
I am pregnant or a parent
I am in, or have been in, foster-care, foster home, or out of home placement
I have a criminal background or am working with probation
I am chemically dependent and/or a child of chemically dependent parents
Date of Birth
What is your mailing address? (Street/Po Box, City, State, Zip)
What are the best ways to reach you? (Choose all that apply)
What services are you interested in?
"Get Started" Virtual Course
HS Credit (or Recovery)
Career Exploration/Job Search
Complete a level of training after high school
What County do you live in?
Do you need an interpreter? If yes, what language
Yes- please list your preferred/needed language on the line below
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