“B.R.I.D.G.E to Success” Enrollment Form
Our intake process strives to provide you with individualized attention to meet your specific needs. This allows us to gather background information about your family unit so we can begin the process of determining the best fit for your current needs. During the COVID-19 pandemic, B.R.I.D.G.E. to Success staff are working remotely and will do our best to connect with you by phone or email.

Program Eligibility:
-The family must reside within Davidson County.
-Child is a student at a Community Achieves Elementary, Middle or High School within Metro Nashville Public School System. This is preferred but not required. Students who attend non-Community Achieves schools are eligible based on meeting the remaining program criteria.
-Child/ren must qualify and/or receive free or reduced lunch via the National School Lunch Program.

Participation Commitment: The BRIDGE to Success Program utilizes a two generational approach, which provides services/resources/programming that will cater to the needs of your entire family. In order to remain in compliance with our program guidelines and successfully track each individual's progress, we require the engagement and activism of all participants: the caregiver/parent and child/ren

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Email *
Name *
Phone Number *
Zip Code *
Age Range *
Gender *
What is your race or ethnicity? *
How many school aged children (in your household), would you like to enroll in this program? *
Do you have a child or children at one of the following schools? *
If answered "Other" for previous question, which Community Achieves affiliation school does your child/ren attend?            https://www.mnps.org/communityachieves
What is the grade level of your child or children? * (For High School Students: 9th and 10th graders are strongly preferred) *
Does your child/ren qualify to receive free or reduced lunch at their school? *
Marital Status *
If married, is your spouse interested in being a program participant as well? *
Highest level of education completed *
Are you currently enrolled in an ESL, GED, Vocational, or Higher Educational Program? *
Current Employment Status *
What is your total household income? *
Are you interested in advancing your job or education? *
Are you open to learning more about healthy lifestyle choices and opportunities? *
Who referred you to the BRIDGE to Success Program? *
What benefit do you most hope to receive from the B.R.I.D.G.E. to Success program? *
Please review and agree to our expectations for BRIDGE Caregivers/Parents: (𝐀𝐥𝐥 𝐞𝐱𝐩𝐞𝐜𝐭𝐚𝐭𝐢𝐨𝐧𝐬 𝐬𝐡𝐨𝐮𝐥𝐝 𝐛𝐞 𝐜𝐡𝐞𝐜𝐤𝐞𝐝 𝐢𝐧 𝐨𝐫𝐝𝐞𝐫 𝐭𝐨 𝐩𝐫𝐨𝐜𝐞𝐞𝐝 𝐰𝐢𝐭𝐡 𝐁𝐑𝐈𝐃𝐆𝐄 𝐄𝐧𝐫𝐨𝐥𝐥𝐦𝐞𝐧𝐭) *
Thank you for completing this intake form and most importantly, your interest in the BRIDGE to Success Program. Once your application is reviewed, you will be contacted regarding next steps. *
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