Program Application

Take the First Step

Fill out the form below and we'll reach out within 24–48 hours to talk through next steps. No commitments. Just a conversation.

Who is filling out this form?

I'm applying for myself

You are the young person seeking support

I'm submitting for someone else

A parent, caseworker, teacher, or other adult applying on behalf of a youth

Your full name

Date of birth (optional)

Email (optional)

Phone (optional)

City (optional)

State (optional)

Select all that apply. You can always discuss more during your intake call.

Pick Your Destination

Self-discovery, career exploration, and goal-setting

Map Your Route

Finances, healthcare, housing, digital literacy, and online safety skills

Get Behind the Wheel

Driving experience, skill-building (financial, communication, career), mentorship, and real action

Meet with your Pit Crew

Safe space, community, belonging, and the people who support you

Share only what you're comfortable with. This helps us connect you with the right support. Everything is confidential.

Current situation

Housing status

Goals or anything else you want us to know (optional)

Applications submitted Friday–Sunday will receive a response within 48 hours. All other submissions within 24 hours.

If you are in immediate danger, please call 911 or the National Runaway Safeline at 1-800-786-2929.