Application

Thank you for your interest in participating in the Teen Mother Choices Program. Before completing Teen Mom Contact Form, please review the criteria for joining the program.

Teen Moms involved in Teen Mother Choices:

Have given birth to their child(ren) and made the choice to parent them.
Are between the ages of 13 - 23 years of age.
Are working to finish their high school education through traditional high school, GED program, or alternative schooling.
If they have graduated from high school, will either then attend college or work towards full-time employment.
Will maintain a grade of at least a "C" in all school classes.
Will delay a subsequent pregnancy while participating in the program.
Will attend weekly LifeSkills Workshops (a schedule for the program's LifeSkills Workshop will be provided by the TMC Program Director)
Will establish and progress towards specific personal goals.
Will sustain a relationship with an assigned Mentor.

I've read the above requirements and understand that in order to become and remain a Teen Mother Choices Program Participant, I agree to them.

I've read and agree to the above statements.

"The TMC®️ Program I am hoping to join is:*

Today's Date

My Name*

First NameLast Name

Birth Date*

How did you hear about Teen Mother Choices?*

Through my schoolThrough a friendSocial MediaOther

Phone Number*

Can we contact you via text?*

YESNO

Email*

example@example.com

How would you prefer to be contacted?*

PhoneEmail

"I am interest in*

finishing high schoolgetting my GEDgoing to college/trade schoolgetting a job

Thank you for taking the time to fill out this Contact Form. Once you have submitted this form, a Teen Mother Choices Program Director will reach out to you.

2025 Teen Mother Choices®️ is a licensed program of Teen Mother Choices International®️.

The Teen Mother Choices®️ Program