Please enable JavaScript in your browser to complete this form.Section 1: Tell us about youFull Name *Address *Email (if applicable): *GenderMaleFemaleAge *Level of Education completed (check all that apply): *FreshmanSophomoreJuniorSenior 5 (post-secondary)CollegeGED List any other areas of completed education such as Trade School, Community or 4-Year College Credits.Section 2: Tell us about your challengesPlease share with us anything you feel has made it harder for you to STEP OUT (Step 1) To STEP INTO DESTINY (Step 2); For example: A felony, single mom, single-parent home, depression etc.My Educational Goal (s) for the next 5 years (circle all that apply): *Finish High SchoolComplete a Trade SchoolGet a Technical college degreeObtain a Bachelor’s degreeOtherMy dream career is to be *A hair stylist, A lawyer, An artist, An engineer, An architect, A professional athleteStart my own business (entrepreneur)Other (Write on back if necessary)What type of Community Project do you believe would help improve Homestead/Steel Valley and surrounding areas?Why would connecting with a youth in Kenya be exciting for you?I believe that I am eligible for this program and the information I have provided in this application was entirely accurate to the best of my knowledge at the time I completed it.SignatureDate MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you are under 18, you must obtain a Parental (Guardian) Consent Form (separate from application). Your printed and signed form can be scanned and emailed to Chelsea Houenou (chelsea@2steps2work.org). Deadline is May 2ndApply
