half full, llc Youth Forward® Application

This survey is an application to attend a Youth Forward experience with half full, llc. Youth Forwards are Personal & Leadership retreats for high school aged youth. They are 3-day, 2-night experiences at an exotic location aimed at expanding the horizons of youth participants with a variety of workshops all based on different social and academic themes.

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* 1. LET’S GET THE STANDARD DETAILS OUT OF THE WAY FIRST: What did your parents name you?

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* 2. DIGITS (Home) 

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* 3. (Mobile Number) ---- (Are you a texter?) YES / NO

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* 4. EMAIL 

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* 5. INSTA 

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* 6. ADDRESS

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* 7. Street, City, State, Zip

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* 8. DATE OF BIRTH 

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* 9. Gender Identification 

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* 10. RIGHTY or LEFTY? 

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* 11. SCHOOL 

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* 12. GRADE 

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* 13. Likes 

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* 14. Dislikes 

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* 15. Ignores 

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* 16. Have you stayed away from home on a retreat before? If so when, and what was it about?

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* 17. Please check which best describes your feelings about not having your phone on the retreat:

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* 18. Please check which best describes your feelings about attending an overnight retreat:

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* 19. Who is the cool Adult/Mentor who encouraged you to apply for this opportunity?

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* 20. Would you be able to get dropped off at a meeting spot in Providence? YES / NO

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* 21. Person to contact in case of emergency 

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* 22. Relationship to person ------- Contact phone 

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* 23. Participant Agreement: By submitting this application, I affirm that the facts set forth in my application for participating in a half full Forward® are true and complete. Thank you for completing this application form and for your interest in attending a half full Forward. All the information recorded above is considered confidential.

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* 24. Youth Signature (Type Full Name)

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* 25. Parent/Guardian Signature (required for all ages because this is an overnight retreat) - Type Full Name

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