BRIDGE Youth Intake Form – BRIDGE RecordEazy

BRIDGE Youth Intake Questionnaire

By completing this Intake form, clients acknowledge releasing the use of their photos, videos, testimonials, solicited feedback and surveys acquired during the Building Rural Innovation and Development for Growing Entrepreneurs (BRIDGE) activities/events for use in BRIDGE’s materials which include but not limited to website, media campaigns, and slide decks.

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Name

First Last

DOB

Grade

Address

Street Address City State

School

Gender

Home Schooled?

Race

What businesses are you currently interested in starting

Do you have a savings account?(Required)

Yes

Do your parent/guardians talk to you about saving money?(Required)

Yes

Are you interested in entrepreneurship/owning a business>(Required)

Yes

Financial & Entrepreneurship

List business interests:

Parent's/Guardian's Full Name

Phone

I am aware that it is my duty to submit truthful information.(Required)

Yes

By submitting this form you acknowlege that you have provided accurate and current information.