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Request Support for Transitioning to Independent Living

Request Y Support for Transitioning to Independent Living

Please use this secure, confidential form to request support for a youth or young adult (ages 15-23) who has, or is preparing to transition out of foster care. Our team will follow-up with you within a few business days. Questions? Email us at ILreferrals@seattleymca.org.

Your Information

Please provide the information requested below so we can connect with you.

First Name

Last Name

Pronouns

Date of Birth

When were you last in foster care?

How may we contact you?

Your Phone Number

Your Email Address

Your Phone Number

Contact me through a friend, family member, school/social services contact, or similar.

Their Phone Number

Their Email Address

Their First Name

Their Last Name

Relationship

Please tell us when and where you are most available (e.g. after school, work, at your residence)

What are your goals?

(select all that apply)

Education

Employment

Housing

Rapport and relationship building

Other life skills

(e.g. navigating systems, wellness, managing finances, sexual health, etc.)

What is or could get in the way of you reaching these goals?

What support do you need most to be successful?

Foster Care Alumni

Request Y Support for Transitioning to Independent Living

Your Information

Contact me through a friend, family member, school/social services contact, or similar.

What are your goals?

EQUITY STATEMENT

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