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* 1. Name

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* 2. Email address

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* 3. Phone Number (and can we text you?)

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* 4. Parents name, email and phone number

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* 5. Current school and grade level

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* 6. List all Thrive events you have participated in (Teen Summit, Summer PopUps, etc.)

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* 7. Race

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* 8. Household income

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* 9. Are available for meetings first Monday of each month 4-5:30 pm and do you have access to  transportation for TAC commitments?

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* 10. Please rate your interest in the following initiatives

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