YouthBuild Application

Applicant Information

First Name

Middle Name

Last Name

Street

City

State

Zip Code

Applicant County of Residence

Please provide a secondary address if you have one.

Mobile Phone

Home Phone

Preferred Phone

Text Message Opt-In

Opt-In

By agreeing to receive text messages, you understand that Tree Trust may occasionally send you text messages related to recruitment, programming updates, deadlines, etc. These are estimated to be no more than 4-7 messages per month. For questions or assistance regarding our text policy or procedures, please call 952-767-3880. You can review our privacy policy at https://treetrust.org/privacy-policy.

Email Address

Email Type

Preferred Communication Method

If someone referred you to Tree Trust, please write their name:

Birthdate (You need to be at least 16 by late October.)

Legal Gender

Gender Identity

Ethnicity (Hispanic/Latino)

What is the last Grade Level you completed in School?

If attend school, what school do you attend?

Are you currently employed?

Emergency Contact Information

Emergency Contact #1 Name

Emergency Contact #1 Phone Number

Emergency Contact #1 Relationship

Emergency Contact #2 Name

Emergency Contact #2 Phone Number

Emergency Contact #2 Relationship

At Risk Information

Funds for this program are targeted to serve youth who have a disability or qualify as low-income or at-risk.

Do you or did you have an Individual Education Plan (IEP) or 504 Plan at school?

Are you a youth in foster care or aging out of foster care?

Are you a migrant youth? (A migrant is any person who is moving or has moved across an international border away from their place of residence.)

Do you have a parent who is currently in jail or prison?

Are you currently a teen parent or pregnant?

Are you currently homeless?

Have you ever been convicted of a crime?

If you've been convicted, was it a ...

Were you convicted as a ...

Are you currently on parole?

Income Information

This information in needed to determine your eligibility.
Do you and/or your parent or guardian receive any of the following types of assistance?

SSI (this must be for the applicant only - not any other member of the family)

TANF (Temporary Assistance for Needy Families)

MFIP (MN Family Investment Program)

TANF or MFIP yes

TANF and MFIP no

General Assistance

Food Stamps (SNAP) Recipient

Family Information

Including yourself, how many people, related to your by blood, marriage, or adoption have lived in the same household in the past 6 months?

For the questions below include as income: gross wages, net self-employment income, alimony, Social Security benefits, rental property income, pensions, dividends, interest on savings, training stipends, grants (excluding Pell Grants), railroad retirement benefits, strike benefits, net gambling or lottery winnings. DO NOT include as income: any form of public assistance, Supplemental Security Income, unemployment compensation, child support received, loans, one-time gifts, lump-sum inheritances, withdrawals from savings account, tax refunds, one-time insurance payments or compensation for injury, payments made on behalf of a foster child, the sale of property, HUD rental assistance programs.

Applicant's Annual Income

Additional Income from other Family Members

Do not include your income in this number

I am over Age 18 and my own Legal Guardian

YesNo

Parent/Guardian's First Name

Parent/Guardian's Last Name

Parent/Guardian's Email Address

Parent/Guardian's Phone Number