Detroit Phoenix Center - SOAR Afterschool Enrichment Program Interest Form

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Our SOAR Program provides a safe and supportive environment for teens in need after-school. When youth enroll in SOAR, they have access to food, washer/dryer, computers, tutoring services, recreational activities, educational and life skills, Tuesday- Thursday from 5-7. Our SOAR program is a hybrid program. Youth can receive drop-in services and or drop-in for SOAR by appointment only. The SOAR afterschool program is for youth ages 12-18.

This form will be used as a membership referral for youth who may qualify for SOAR.

Email *

Student Name

Student Organization/ School *

Why are you referring this student? (If student referral - please note) *

Parent/Guardian Name (if applicable)

Address (if applicable)

Phone Number

Participant Age *

13-18 (please check if still enrolled in high school)

18-24

10-12

Required

Reason for Referral

Basic Need Support (hygiene kits, washer/dryer, bus tickets, food, shower)

Educational Support (tutoring or academic coaching)

Life Skills Support (financial literacy, cooking, computer skills)

After School Enrichment (Tuesday- Thursday 4-8)

Unaccompanied Youth (13-17, not in the physical custody of parent or guardian)

Identification Needs (State ID, Birth Certificate)

Mental Health Support

Other:

If the student is seeking Afterschool Enrichment, which enrichment activities?

ACT/SAT Prep

Yoga Club

Hair + Self esteem

Gaming Warriors

Financial Literacy

Resume Building/ Career Readiness

Theatre For Life

Other:

Any other information that we should know?

Submit

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