Signature summer program

Elevated Thinking

Job and career readiness taught through hands-on assignments — applications, interviews, attire, attitude and professionalism — preparing teens emotionally and practically for work and life after high school.

Ages: 13–18
Where: Daytona Beach
Cost to family: [CONFIRM]

Program participants with the executive director

Youth information

First name

Last name

Birthdate

Current age

Gender

Female Male

Mailing address

City

State

ZIP code

Home phone

Youth’s email

If they have one of their own.

School name

Current grade level

Why we ask

The questions below help our mentors support your child well from day one. They are shared only with program staff.

Medical and safety information

Medical conditions or special needs

What motivates your child?

How does your child learn best?

Any special behavioral, social or emotional needs?

Parent or guardian

First name

Last name

Your signed copy is sent here.

Home phone

Cell phone

Work phone

Emergency contact

First name

Last name

Relationship to youth

Address

Home phone

Cell phone

Work phone

Consent and signature

I give permission for my child to participate in Strength to Elevate programming, including transportation to and from program activities and the use of photographs taken during the program.

Parent or guardian name

Date

Signature

Sign here with your finger, stylus or mouse

Not yet signed

Data storage agreement

I consent to Strength to Elevate storing the information submitted in this form so they can respond to my inquiry and administer my child’s participation.

This form needs JavaScript enabled. If you would rather not, call us on 301-642-8265 and we will take your details over the phone.

A signed PDF copy is emailed to you and to our program team as soon as you submit.

Elevated Thinking

Enrollment received.

Youth information

Parent or guardian

Emergency contact

Consent and signature

Data storage agreement