TYCCA Program Interest & Information Request

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Thank you for your interest in The Youth Connection Career Academies! Please complete this form to receive more information and be added to our waiting list. As program openings become available, someone from our team will contact you regarding the enrollment process. Submission of this form does not guarantee program enrollment. Detroit Residents ONLY for Career Pathways and Summer Employment Programs.

Participant's First Name *

Participant's Last Name *

Participant's Email Address *

Participant's Date of Birth *

YYYY

Participant's Phone Number *

Participant's Address *

Participant's City *

Participant's Zip Code *

What school does the participant attend? *

Parent's First Name *

Parent's Last Name *

Parent's Email Address *

Parent's Phone Number *

Which program(s) are you interested in? *

Career Pathways Year Round

Summer Employment

RISE - Youth In Transition (YIT) Services

Required

Would you like to be added to our waiting list? *

Please add my name to the program waiting list.

Please add my name to the program waiting list AND send me more information.

How did you hear about us? *

Submit

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