All about you! Name of Youth* Advocate's Name Date* MM slash DD slash YYYY What would you like to see happen as a result of joining the Empower program?*What are your interests and/or hobbies?*What would you like us to know about you?*Have you ever previously worked with someone from the Foundation?*What makes you a good candidate for the Empower program?*Relevant cultural information*Do you have any special abilities and/or needs?*Do you have a laptop or computer?* Yes No Do you have internet access at home?* Yes No What are some accomplishments you would appreciate being recognized for by your advocate?* Good Grades Good Behavior Good Attendance Other If other, please describe*What would you find meaningful in being recognized for your accomplishments?* Verbal Acknowledgement Personal Note or Card Lunch with Advocate Other If other, please describe*In what type of setting are you most comfortable with in receiving recognition?* Private Small-Group Public No Preference Favorite Drink* Favorite Snack* Favorite Dessert* Favorite Food* Favorite Restaurant* Favorite Store* Favorite Music Artist* Favorite Sports Team* Favorite TV Shows or Movie*
