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Brady Support and Resources
school
* Indicates required question
Email
*
Record my email address with my response
Date
MM
/
DD
/
YYYY
Last name:
Your answer
First name:
*
Your answer
What is the best number to contact you?
*
Your answer
My Brady plan and goal
*
Earn my high school diploma and complete additional training (apprenticeships, certificate programs)
Earn my high school diploma and enter the work force
Earn my high school diploma, then I am not sure ******
Earn my high school diploma and attend a 2 or 4 year college or university
Earn my high school diploma and enter the military
Other:
My dream career is:
*
Your answer
What areas would you like help with?
yes
no
Mental health
Food, housing, clothing
Substance abuse
Family/Relationship issues
Study Skills
Future Plans After Brady
Help finding a job
Suicidal thoughts, thoughts of hurting others
Quitting smoking
Health Care/Health Insurance
yes
no
Mental health
Food, housing, clothing
Substance abuse
Family/Relationship issues
Study Skills
Future Plans After Brady
Help finding a job
Suicidal thoughts, thoughts of hurting others
Quitting smoking
Health Care/Health Insurance
Any other areas you would like help?
Your answer
What you are good at OR what are you proud of?
*
4 points
Your answer
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