Wings to Stand Interest Form
The Wings to Stand program seeks to empower youth through education, mentorship, emotional support, and real-world preparation. The program will be held at the Denbigh Community Center. Upon selection into the program, participants will receive a welcome letter and additional information.
Student Information
Full Name
*
First Name
Last Name
Current School Name
*
Current Grade/Year
*
Please Select
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Other
Why are you interested in this program?
*
What real-world experiences or hands-on learning activities are you most interested in?
Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Recommendation Provider
Please provide the email address of one person who could recommend your child for the program. It may be a teacher, counselor, or a member of their community who could speak on their demeanor, motivation, and cooperation.
Recommender's Email Address
*
example@example.com
Consent and Confirmation
Parent/Guardian Consent Signature
Consent Signature Date
-
Month
-
Day
Year
Date
Submit Application
Should be Empty: