Program Registration Form

We are excited to meet you!
Please complete the form and submit. Once submitted within 48 hours you will be contacted by a LITE staff member to take about next steps.

The information gathered is used to identify resources to serve you and to help you achieve your goals. A LITE Leader will contact you within 48 hours of submission of this form.

We look forward to seeing you soon.

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New registration
Name
Address
Are you between the ages of 16 – 24?
How do you identify?
Please select race and ethnicity
Are you in school?
If not in school, what is the highest grade you completed?
Identify the service that would best help you.
Choose the services that help you discovery your pathway to higher earning potential and adulthood.
What is your current employment status?
Do you know what your dream job looks like?
Do you have transportation?
Parent or other significant adult Name
Consent for Promotional Purposes – permission to Leaders In Transformational Education (LITE) to use artwork, writing or pictures/videos taken at this event for the promotional purposes. I understand that refusal to sign this release will not affect delivery of service in any way. I am 18 years old or older/ I am a parent or guardian of a child under 18 years of age
Thank you for visiting our website. If you are not between the ages of 16 – 24, please check out the websites below for employment assistance.
If you are looking of other assistance than what is listed above, submit your form and we will try to assist you.