Intake Form

🔐This page is only for the registrants of the Grinding to Glory Youth Empowerment Summit. Only the registered young men and their parents/guardians should complete this form. Must be completed before the event.

Follow these instructions to complete the application form.

✅Each youth must be 13 years or older to receive a device

ONE application is required for each young man attending the event

IF anyone other than the young man is completing the form, please select “Filling it out on behalf of someone else” for the first question

When completing the form, EVERYONE must select “None of the above- put me on the waitlist" when selecting the event you are attending

All forms completed for a minor requires a signature from the minor and a parent or guardian

✅ Each young man's name, address, date of birth, phone number (if applicable) and email (if applicable) should be entered on every application submitted

✅ List "student" as the employment status for all minors

Full Online Experience Coming Soon…