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KAI Partners, Inc.

1512 Eureka Rd. #215 Roseville, CA 95661

1-916-465-8065

info@kaipartners.com

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YOUNG ADULT APPLICATION FOR MEMBERSHIP (AGES 18 - 25)

* Initial selection deadline closed 11/17/2023. Application will remain open for quarterly review to ensure full membership body and waitlist.

IF SELECTED, I AGREE TO THE ELIGIBILITY AND COMMITMENT REQUIREMENTS LISTED ABOVE.

PERSONAL INFORMATION

Legal Name
Legal Name
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DEMOGRAPHIC INFORMATION

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Lived Experiences - Select all that may apply.
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YOUTH APPLICATION FOR MEMBERSHIP (AGES 14 – 17)

* Initial deadline closed 11/17/2023. Application will remain open for quarterly review to ensure full membership body and waitlist.

IF SELECTED, I AGREE TO THE ELIGIBILITY AND COMMITMENT REQUIREMENTS LISTED ABOVE.

PERSONAL INFORMATION

Legal Name
Legal Name
First
Last
Pronouns
Address
Address
City
State/Province
Zip/Postal

DEMOGRAPHIC INFORMATION

Gender Identity
Sexual Orientation
Racial Identity
Lived Experiences - Select all that may apply.
Start Over