🌟 Live The Dream Alliance – Participant Intake Form

🌟 Live The Dream Alliance – Participant Intake Form
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Welcome to Live The Dream Alliance (L.T.D.A) — a community built to help youth and families achieve growth, opportunity, and success. Please take a minute to fill out this short intake form so we can connect you with the right program, resource, or support service. We keep your information private and only use it to help match you with the best opportunities.
SECTION 1 — Personal Information
1. Full Name:

First NameLast Name
2. Phone Number:
Please enter a valid phone number.
3. Email Address:
example@example.com
4. Preferred Contact Method:

PhoneWhatsAppEmailText Message
SECTION 2 — Basic Details
5. Age Range:

Under 1313–1718–2425–3030+
6. What are you interested in?

Dream Learners (ages 0–7)Dream Builders (ages 7–13)Dream Leaders (ages 13–18)Re-Entry Success Program (RSP)Career Development / JobsVolunteer OpportunitiesStaff / EmploymentGeneral Information or Support
7. What kind of support are you looking for right now?
(Short answer — e.g. “I need help finding a job,” “I want to go back to school,” “I’m looking for mentorship,” etc.)
SECTION 3 — Location
8. What area do you live in?

Toronto (Downtown)ScarboroughEtobicokeNorth YorkEast YorkYork RegionOutside TorontoPrefer not to say
SECTION 4 — Consent
9. Consent to Contact

I agree to be contacted by Live The Dream Alliance by phone, WhatsApp, text, or email.
10. Privacy Statement:

Your personal information will only be used to help connect you with (L.T.D.A) programs, staff, or community resources. We never share your data without your permission.
Should be Empty:

🌟 Live The Dream Alliance – Participant Intake Form

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SECTION 1 — Personal Information

SECTION 2 — Basic Details

SECTION 3 — Location

SECTION 4 — Consent