Apply to Participate in the Trenton PEERS Program

Trenton PEERS

In order to join the Trenton PEERS program, you must meet the following eligibility requirements:

Trenton resident attending a Trenton High School with a GPA of 3.0 or higher
School attendance of 85% or higher
Desire to pursue higher education – college, trade school, military, etc. post high school
Willing to be a PEER role model and perform skits/workshops on making responsible choices
Commitment to attend a weekly PEERS meeting – Tuesday or Thursday (5:00-8:00 p.m.) depending on your grade.*
Interview required

* Transportation and a dinner meal are provided. Eligible for a $250 dollar quarterly stipend based on attendance and participation.

Please complete the application form below to participate in the Trenton PEERS program. For questions please email or call Micayla Weissburg, Youth Engagement Manager: (609) 989-7333 ext 122 mweissburg@millhillcenter.org

Student Information
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email
Birthday*
Month
Day
Year
High School You Attend
Current Grade
Do you have access to a computer, tablet, or cell phone with access to the internet?
- Yes
- No
- Sometimes
Please select the size of your household
Please select your annual household income range
Signature
Hidden
Date
Parent / Guardian Information
Parent / Guardian Name(s)
Address
Street Address Address Line 2 City State ZIP Code
Daytime / Work Phone
Evening / Home Phone
Cell Phone
Email
Signature
Questions
Please answer the following questions in a few sentences in the space provided.
What do you plan to do after your high school graduation? What action steps have you taken to reach your goals so far?
What activities or programs are you involved in? (sports, music, band, clubs, other school programs, community programs, church programs, etc.). What skills have you developed by being in these programs?
Describe a team project you are most proud of. What did you specifically do?
Describe a challenge or obstacle you faced and how did you overcome it?
What community service or volunteer work have you done in the past 1-2 years?
What do you hope to achieve from being a participant in this program?
Comments
This field is for validation purposes and should be left unchanged.

Apply to Participate in the Trenton PEERS Program

Student Information

Parent / Guardian Information

Questions

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