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About Us
Our Programs
Giving
Contact
Apply now
LifeSkills Referral Form
GiveBack Application Form
Volunteer Form
Sponsor Us
Join The Team
LifeSkills Application
PROGRAM REVIEW PDF
Applicant Name
*
First Name
Last Name
Preferred Name
Birthdate
MM
DD
YYYY
Age
Email
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Cell
(###)
###
####
May We Leave a Message
Yes
No
Race / Ethnicity
White
Black
Asian
American Indian
Hispanic
Other
Primary Language
English
Spanish
Other
Name of person(s) applicant lives with:
Is this their legal guardian?
No
Yes
High School Information (FOR PROGRAM REFERRALS ONLY)
High School Attended
Current Grade Level
Shirt Size
Adult Small - 3XL
Reason For Referral
Referral Name
BTP board member(s) may override any granted parental permission if the situation does not seem to be consistent with the program’s regulations or is deemed not to be in the best interest of the applicant.
Taxi /Uber /Other Car Services
My student must have a BTP staff member call home each time they wish to ride in a taxi/ uber/car service
My student may ride in a taxi/uber/car service within the city of Lexington KY
Personal Vehicles
My student may ride in cars at their discretion (with any licensed driver)
My student may ride in cars with adult licensed drivers (25 & over) at their discretion; however, they must call home anytime they want to ride with anyone under the age of 25.
My student may ride in cars with the following licensed drivers. BTP will call home for anyone not listed below.
List: Name / Phone
Thank you! Someone will contact you soon! -BTP
