Teens in the House Application First Name * Last Name * Preferred Name * Mailing Address * Phone Number * Student Email Address * Parent Email Address * Emergency Contact 1 * Phone Number * Relationship * Emergency Contact 2 * Phone Number * Relationship * Where do you attend school? * I am a rising 6th grader 7th grader 8th grader 9th grader 10th grader 11th grader 12th grader this is the grade you will be in Fall of 2020 Which program week are you interested in attending? * June 29 - July 2 (High School) July 6 - 9 (Middle School) July 13 - 16 (High School) July 20 - 23 (Middle School) How did you hear about Teens in the House? * Please list any dietary restrictions If you had to describe yourself in three adjectives, what would they be? * What is your dream job? * Why are you interested in Teens in the House? * Please answer this question in paragraph form (4-6 sentences) What do you want to learn during a week of service-learning at the Family House? * Please answer this question in paragraph form (4-6 sentences) What's your favorite story related to a time when you showed someone hospitality, compassion or support? * Please answer this question in paragraph form (4-6 sentences) How have other experiences (extra-curricular activities, classes, etc.) prepared you for an opportunity like this? * Please answer this question in paragraph form (4-6 sentences) I understand that this is an application for and not a commitment or promise of a service opportunity. * Yes Students will be informed of acceptance within two weeks of applying. I understand that my clothes should be comfortable, professional, and well-suited for an internship environment. Clothing should cover torso, midriff and backside and have sleeves or thick straps. Clothing should have no holes or rips. Close-toed shoes should be worn and long hair secured when preparing food. * Yes I certify that all information I provide during the selection process will be true, correct, and complete to the best of my knowledge. * Yes I understand and support the mission of the Family House and agree that any information I receive, directly or indirectly, regarding any guest, will be kept in strict confidence. * Yes I understand the program fee is $70. * Yes You will be contacted by a Family House staff member with payment details. I would like to apply for a need-based scholarship * No Yes A Family House staff member will get in touch with you with details. Electronic Signature * reCAPTCHA Submit If you are human, leave this field blank.