Inquire/Referral

How have you been impacted by Foster Care*

Aging-out/Aged-out of Foster CareSpent Time in Foster CareNeither

It looks like you don't qualify to apply for the JEMfriends Independent Living Program. Thank you for your interest!

Tell us about your current situation:
Please check all that apply to you

In foster careAged out of foster careWill age out in the next 6 monthsHomelessIn highschoolLiving in temporary housing situationEmployed
Tell us about your current goals*
Tell us about current obstacles keeping you from completing your goals*
What are questions you have about JEMfriends that we can answer for you?*

Your (Referrer) Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Best time to reach you?*
Who are you referring to the JEMfriends Independent Living Program?
Referee's Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Best time to reach them?*
Their Age*
What is the relation between yourself and who you are referring to JEMfriends?*
Why would you like to refer them to JEMfriends?*
How would you prefer JEMfriends to proceed with this referral?*

I would like to speak to someone about this referralI would like you to directly reach out to the individual I have referred

Please fill out the remaining questions about the person you are referring to JEMfriends to the best of your ability.
How have they been impacted by Foster Care?*

Aging-out/Aged-out of Foster CareSpent Time in Foster CareNeither

It looks like the individual you are referring doesn't qualify to apply for the JEMfriends Independent Living Program. Thank you for your interest!

Tell us about their current goals*
Tell us about current obstacles keeping them from completing their goals*
What are questions you have about JEMfriends that we can answer for you or your referral?*

Who are you referring to the JEMfriends Independent Living Program?