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Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Best time to reach you?
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Age
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Tell us about your current situation:
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Please check all that apply to you
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In foster care
Aged out of foster care
Will age out in the next 6 months
Homeless
In highschool
Living in temporary housing situation
Employed
Tell us about your current goals
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Tell us about current obstacles keeping you from completing your goals
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What are questions you have about JEMfriends that we can answer for you?
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