EMI New Participant Sign-up
Thank you for your interest in EMI. Our goal is to assist youth and their family's with ultimate achievement and wellbeing. We present programs and solutions to ; job readiness, career goals, higher learning pursuits, Juvenile detention diversion, family cohesiveness, and Mentoring. Please complete each portion of this application so that our dedicated staff may serve you in a timely manner. 
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Email *
Name of New Participant *
Name of Parent or Guardian *
Parent Email *
Phone Number
Number of Household members
How were you referred to EMI services? *
Required
Age of the Participant *
Required
Check the box next to your interest *
Required
Do you or any others in your household have interest in the following? (check all that apply)
Other information on the applicant *
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