Futures First: Program Interest

Welcome to FUTURES FIRST!

Futures First is a program of the April Parker Foundation designed to empower young people ages 16–30 with housing, coaching, education, workforce opportunities, and mental health support. We believe youth are the authors of their own lives — our role is to provide resources, mentorship, and navigation to help you build stability, resilience, and independence.

This short form is your first step. By completing it, you let us know you’re interested in learning more about Futures First and allow us to follow up with you directly. Your information will remain private and only be used to connect you with program opportunities and supports.

✨ What happens next?

Once you submit this form, a Futures First staff member will contact you within 3–5 business days.
We’ll schedule a time to talk more about your goals, needs, and how Futures First can support you.
If you’re eligible, you’ll move to the enrollment stage where you’ll complete intake and orientation.
Your journey toward independence starts here — thank you for raising your hand and taking this step!

What is your age?

Are you between the ages of 16 and 30 years old

Yes

What is your gender identity

Man

Woman

Non-Binary

Are you currently attending high school or college/university?

Yes

Please choose the option that best describes your housing situation

I currently have stable housing

I have temporary housing

I do not have housing

Are you currently working full-time?

Yes

Are you currently working 20 hours or less?

Yes

Please check all that apply to you

Currently/previously in Foster Care

Pell grant recipient

Justice-impacted

Currently receiving public assistance

Name* This field is required.

First Name

Last Name

E-mail

example@example.com

AddressPlease skip if you do not have housing

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Date of Birth* This field is required.

Date

Phone Number* This field is required.

Area Code

Phone Number

Which program were you referred by?

Do You have Medical Insurance?

Yes

I don't know

Type option 4

Who is your managed care plan provider?

Medi-Cal

L.A. Care Health Plan

Health Net

Molina Healthcare

Anthem Blue Cross Medi-Cal

Kaiser Permanente

Inland Empire Health Plan

CalOptima (Orange County)

Partnership HealthPlan of California (PHC)

Central California Alliance for Health

Community Health Group

Contra Costa Health Plan

San Francisco Health Plan

Gold Coast Health Plan

Health Plan of San Joaquin

Health Plan of San Mateo

Kern Family Health Care

Valley Health Plan (Santa Clara)

NEXT STEPS

Next steps in the process involve our team reaching out to you in order to schedule a brief meeting. We understand that your schedule may be busy, so we will work with you to find a suitable time for these meetings, which typically occur on a weekly basis.

During these meetings, you will have the opportunity to learn more about the Futures First Program, its objectives, and the specific benefits it offers. This is your chance to gain a deeper understanding of how the program can support your personal and career development goals.

If, after learning about the program, you find it interesting and meet the eligibility criteria, you will be enrolled into the Futures First Program. We are excited to embark on this journey with you and look forward to assisting you in reaching your educational and career aspirations.

is Participant Eligible ?

YESNO

Futures First: Program Interest