Boys To Men Form - Boys Champions

Boys to Men Program Application Form

Personal Information

Enter Full Name

Date Of Birth

Grade Level

Phone Number

Age (Must be 10 t0 18)

School/Organization

Address

Email Address

Skills and Interests

Please select the up to three skills and activities you're interested in or would like to explore during the program (choose only three that apply)

Music (Learning instruments, writing songs, or performing)

Arts (Painting, drawing, creative expression)

Sports (Soccer, basketball, fitness, and team-building)

Entrepreneurship (Business ideas, budgeting, and financial skills)

Public Speaking (Improving communication and leadership skills)

Mental Health (Stress management, emotional healing)

Civic Engagement (Community service, social justice)

Tech Skills (Graphics design, photography, videography)

Program Commitment

The Boys to Men Program meets twice monthly on the 1st and 3rd Saturdays from 10:00 AM - 2:00 PM, starting in April 2025. Can you commit to attending these sessions and activities?

Yes, I can commit to attending.

No, I have concerns about availability.

Short Personal Statement

Please share why you would like to be part of the Boys to Men Program and what you hope to learn. Keep it brief.

Emergency Contact Information

Full Name

Phone Number

Relationship To Applicant

Parent/Guardian Information

Parent/Guardian Full Name

Phone Number

Relationship To Apllicant

Email Address

I, the undersigned, give my consent for my child to participate in the Boys to Men Program. I understand that my child will be involved in various activities, including sports, music, mentorship, and community engagement. I agree to support my child's participation and any necessary transportation arrangements.

Parent/Guardian Signature

Date

Boys To Men Application

Personal Information

Skills and Interests

Program Commitment

Short Personal Statement

Emergency Contact Information

Parent/Guardian Information