CTB Youth Network Application Form

Thank you for enrolling your teen in the Crossing the Bridge Youth Network Program. We appreciate your support and commitment. Please complete all required information on the application form below. As parents, your involvement plays a vital role in your child’s success:

Project Support We encourage parents to assist their teens with program projects. Your guidance and experience make a meaningful difference.

Attendance Please ensure your teen attends every meeting on time. Consistent participation is essential for their growth and development.

Encouragement Motivate your teen to dream big. Entrepreneurship requires creativity, confidence, and resilience—and your encouragement matters.

Consent Form A signed consent form is required for all participants. If you do not have it today, you may submit it on the first day of the program.

Our program includes mentorship, financial foundations, career preparation, youth entrepreneurship, Teen Talk Sessions, health and wellness, and teen journaling with spiritual growth.

Thank you for being part of this exciting journey.

Date

MonthDayYear

Student Name

First NameLast Name

Select One:

FemaleMale

Student Date of Birth

Age

Grade

Student Cell Phone Number

Area CodePhone Number

Student Email

example@example.com

School Name (Please give FULL name and not an abbreviation)

School City

School County

Select One:Drop Out School

NOYES

Select One:Do You Have PC or Tablet with WiFi

NOYES

T-shirt Size (Best efforts will be made to provide the size selected. Some vendors do not offer certain sizes).

What subject(s) would you like to learn about or are you interested in?

Talents: (What do you do best?)

How can any of our program can help You.

Parent/Guardian #1 Name

First NameLast Name

Parent/Guardian #1 Home Phone Number

Area CodePhone Number

Parent/Guardian #1 Cell Phone Number

Area CodePhone Number

Parent/Guardian #1 Email

example@example.com

Parent/Guardian #2 Name

First NameLast Name

Parent/Guardian #2 Phone Number

Area CodePhone Number

Parent/Guardian #2 Cell Phone Number

Area CodePhone Number

Parent/Guardian #2 Email

example@example.com

Emergency Contact Name (If parent/guardian is not available):

First NameLast Name

Emergency Contact Home Phone Number

Area CodePhone Number

Emergency Contact Cell Phone Number

Area CodePhone Number

Emergency Contact Email

example@example.com

Relationship

PLEASE UNLOAD ALL FORM HERE.

Please upload parental/guardian consent form, if you have it available. If you do not have the form, one will be provided following the application submission.

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