A.C.E.S Youth Development Program Registration Form

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Complete this form to register for the You Saved Me Foundation's A.C.E.S. Youth Development Program. A.C.E.S's objective is to enhance and expand positive experiences, opportunities, and resources in underserved communities through our Youth and Young Adults. Youth ages 13- 20 living in San Diego County, CA are encouraged to apply.

We believe in providing a safe space in the community to create multiple paths for success in art, commerce, entrepreneurship, and sports to create, develop and secure lucrative business or career objectives.

Youth will have access to career, self-defense lessons, sports and wellnes training. Youth, can also expand educational skills through mentorship and tutoring & find support for college access for all youth. We encourage first-generation potential college students to apply (meaning no one in the family has yet to attend and graduate college).

Email *

Phone Number *

First Name of Student/Youth/Young Adult *

Last Name of Student/Youth/Young Adult *

Student/Youth/Young Adult applicant Birthdate *

YYYY

Address of Student/Youth/Young Adult *

City of Student/Youth/Young Adult *

State of Student/Youth/Young Adult *

Zip Code of Student/Youth/Young Adult *

Does the Student/Youth/Young Adult identify as a part of any of the groups below? *

Identify as a Person of Color

Identify as Disabled

Qualify for Free Lunch at school

Left school prior to Graduating

Live in an Underserved Community

No one in family has graduated College

Required

Which best describes the Student/Youth/Young Adult Race/ Ethnicity? *

Asian/Pacific Islander

Black/ African American

Caucasian/ White

Hispanic/Latino

Indigenous/ Native American

Is the Student/Youth/Young Adult applicant between the ages of 7 to 20 years old? *

Yes

How old is the Student/Youth/Young Adult? *

Is the Student/Youth/Young Adult currently enrolled in school? School enrollment is not required. Drop-out students are welcome in the program. *

Yes

If enrolled, what is the Student/Youth/Young Adult school's Name?

What is the Student/Youth/Young Adult current grade level, or the last grade attended if not currently enrolled? *

Elementary Kindergarten - 6th Grade

Middle School 7th - 8th Grade

HS Freshman 9th Grade

HS Sophomore 10th

HS Junior 11th Grade

HS Senior 12th Grade

Not enrolled in school

College

Who is completing the registration? *

Parent on behalf of Student/Youth/Young Adult applicant

Student/Youth/Young Adult applicant between 7-20?

Please Type Your Name Below as Your Signature *

Your Birthdate *

YYYY

Submit

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