Referral Form for Hood River County Youth Programs

Referral Form for Hood River County Youth Programs

Youth NOW Program (New Opportunities for Work) and Youth Reengagement in School
HR Youth NOW Program: The Hood River County Youth NOW program provides essential employability skills to youth to support entry into the workforce, into training programs or education, or to find a new career path.

We provide one on one support such as communication skills (resume writing, interviewing skills), help with technology, basic academic skills (writing, budgeting, math) and help to connect with other resources in the community.

We work with employers directly to support successful placement.

We will help determine the best employment or training program that meets the individuals own goals.

School Reengagement Program:

The goal of the Youth Reengagement Program is to provide students with the support they need to graduate from high school or earn a GED. We provide one-on-support, help with goal-setting, transportation, mentoring, tutoring and advocacy, as well as other wrap-around support based on individual needs.

BOTH PROGRAMS will help refer students to other supportive resources and services, and offer financial support for basic needs.

ELIGIBILITY: Both programs are for people ages 14-24 and ONE of the below:

Youth NOW:
- Out of school OR
- Unemployed or underemployed (need a career) OR
- Reengaging in education
Reengagement Program:
- Out of school OR
- In danger of leaving school OR
- Attending school but behind in credits
For more information contact Hood River Prevents at HRprevents@gmail.com or complete this referral form and you will receive a call within 2 business days. If you have any questions call 541-386-2500
Referral information:

Please complete as much relevant information as possible.
Referrer Name (who is making this referral):

First NameLast Name
Referrers Organization
Referrers Contact Info (phone or email or both):
I would prefer to be contacted via:

EmailPhoneOther
Your relationship to the person you are referring? (or self if referring yourself)
Do you want to be followed up with after we meet with the participant?
Additional information you would like us to know
Participant Information
Which program are you referring to?

Youth NOW (New Opportunities for Work)School Reengagement ProgramUnsure
Participant Name:

First NameLast Name
Participant E-mail:
Participant Cell Phone:

Area CodePhone Number
Participant date of birth

MonthDayYear
Date
Participants Preferred language

EnglishSpanishOther
Participants current grade in school:
Participants last school enrolled in:
Primary parent/ guardian name:
Primary parent/ guardian email:
example@example.com
Primary parent/ guardian cell phone number:

Area CodePhone Number
Secondary parent/ guardian cell phone number:

Area CodePhone Number
Reason for referral: Re-Engagement Program (pick all that apply):

Out of schoolIn danger of leaving schoolAttending school but behind at least 3 creditsNeed help with diploma/ GEDOther
Reason for referral: HR Youth NOW Program:

Find employmentHelp decide on a career pathBetter employmentExplore training programsExplore education programsOther
If youth is under 18, please upload a Release of Information. You can also upload a HRCPD Transportation Form. If you need access to the forms see the links below

Browse Files

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The following HR Prevention Department Youth Program forms can be accessed by clicking on the links below:
- HRCSD Release of Information (English)
- HRCSD Release of Information (Spanish)
- HR Youth Program Release of Information (if needed) English & Spanish
- HRCPD Transportation Waiver
If you have any questions submitting this form please email suzanne@supportcultivation.com or HRprevents@gmail.com
Should be Empty:

Referral Form for Hood River County Youth Programs

Referral information:

Participant Information