Registration Form- Pathways to Independence

Registration Form

Pathways to Independence is a 9-week, group-based life skills program designed to prepare youth for successful transitions to adulthood and independent living. The program focuses on practical, real-world skills, including communication, emotional self-management, decision-making, time management, financial awareness, healthy relationships, daily living skills, problem-solving, and transition planning.
Schedule: Monday, October 5, 2026, Monday, October 12, 2026, Monday, October 19, 2026, Monday, October 26, 2026, Monday, November 2, 2026, Monday, November 9, 2026, Monday, November 16, 2026, Monday, November 23, 2026, Monday, November 30, 2026
Youth's Full Name:

First NameLast Name
Age:
example@example.com
Youth's Email Address:
example@example.com
Youth's Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian's Name:

First NameLast Name
Parent/Guardian's Email:
example@example.com
Parent/Guardian Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Do you live in either Sussex or Morris County?
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Should be Empty:

Registration Form