Now Accepting Interest Forms

Youth Basic Needs Partnership Application

The Heights Movement, in partnership with United Way of Greater Cincinnati, is accepting applications for a youth and young adult support program focused on stability, basic needs, leadership, workforce readiness, and overall well-being.

This application helps us understand your needs, goals, interests, and the best program role or support pathway for you.

Basic NeedsFood, housing, transportation, and emergency support

Growth PathwaysWorkforce, media, farming, wellness, and leadership

Participant VoiceYour story helps shape future youth programs

Before You Apply

Completing this form does not guarantee acceptance. The Heights Movement will review applications, confirm eligibility, and contact applicants with next steps. If the applicant is under 18, parent/guardian consent may be required before full enrollment.

Important: This program may include participant check-ins, surveys, and monthly reporting. Participants must be willing to stay in communication with The Heights Movement and complete required program updates.

1. Applicant Information

Tell us who is applying.

First Name *

Last Name *

Date of Birth *

Age * Recommended program range may include youth and young adults. Final eligibility will be confirmed by THM.

Phone Number *

Email Address

Home Address or Current Mailing Address

City

ZIP Code

Best way to contact you *

2. Parent / Guardian Information

Complete this section if the applicant is under 18.

Parent/Guardian Name

Parent/Guardian Phone

Parent/Guardian Email

3. School, Work, and Current Status

Current school/training status *

Name of school, program, or training site if applicable

Current work status *

What are your top goals for the next 3–6 months?

4. Program Track Interest

Select the areas that fit your interests. This helps THM place you in the right role, support pathway, or leadership opportunity.

Youth Basic Needs Support Workforce Development Urban Agriculture / Jackson Street Farms Media / Digital Storytelling Financial Literacy / Entrepreneurship Education / School Support Wellness / Reset Room Family Stability / Community Support Not sure yet

Track Descriptions

Workforce DevelopmentJob readiness, trades, professional skills, certifications, entrepreneurship, and employment support.

Urban AgricultureFarm work, food access, gardening, nutrition, Jackson Street Farms, and community growing.

Media / Digital StorytellingPodcasting, video, photography, editing, content creation, branding, and social media.

Wellness / Reset RoomStress support, emotional well-being, mindfulness, wellness events, and healthy lifestyle practices.

7. Availability and Participation

When are you usually available? Select all that apply.

Are you willing to complete short weekly or monthly check-ins if accepted?

Are you willing to share updates about how the program is helping you?

8. Emergency Contact

This helps us contact someone if we cannot reach you or if there is an urgent concern.

Emergency Contact Name

Emergency Contact Phone

Relationship to Applicant

9. Final Questions

Is there anything else you want us to know?

Participant Understanding: By submitting this application, I understand this is an application and does not guarantee acceptance. I understand that if accepted, I may need to complete check-ins, surveys, consent forms, and program updates. I also understand that The Heights Movement does not provide tax, legal, or financial advice.

I confirm that the information provided is true to the best of my knowledge. * I give The Heights Movement permission to contact me about this application. *

After submitting, The Heights Movement will review your application and contact you about next steps. Please make sure your phone number is correct.

SUPPORT

CONTACT

info@theheightsmovement.com