Welcome youth and families!
Please fill this short form out and then check your email, we will be in contact shortly!

NOTE:
All DFA programming will be virtual (on Zoom or Googlemeet) with the option of in-person opportunities in 2022.

Youth First Name:
Youth Last Name:
Youth Email *THIS is the email an automatic response will be sent to after you submit this form:
Youth Birthdate mm/dd/yy:
Youth Phone Number (including area code, ex: 313-555-5555)

Youth Grade in September 2021, *NUMBER ONLY* Example: 8, not “8th”:
Current School Name:

We send groceries and supplies home, what is the best address to send these to?
Street:
City:
State:
Zip:


Parent Full Name:
Parent Phone Number:
Parent Email:

Please select the days that are most preferable to you.
DFA Afterschool Programs typically run 4:00 – 6:00pm one day a week.

First Choice: –None– Tuesday Wednesday Thursday No Preference
Second Choice: –None– Tuesday Wednesday Thursday No Preference


Is this the first time you are applying to Detroit Food Academy? –None– Yes No
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