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Statistics of children who age out of
foster care without a family

Less than half will have graduated from high school
Nearly 2/3 of girls will be pregnant by age 21
All have exponentially higher risk of becoming a victim of human trafficking

One in four will be in trouble with the law within just two years of aging out
One in five will become homeless
One in four will experience Post Traumatic Stress Disorder in their lifetime (more than twice that rate of U.S. veterans of war)

A group of students at The Bridge House

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Join our team of dedicated volunteers and make a difference in our community. We offer a variety of opportunities for you to get involved. Contribute your time and skills to a cause that matters, build meaningful connections, and experience the joy of giving back. Explore our volunteer opportunities to find the perfect fit for you. Together, we can create a positive impact!

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GENERAL INFORMATION

First Name

Last Name

Current Address or Living Situation :

City/State

Zipcode

Phone

Email

Date of Birth

Social Security Number

Gender

Race

Sexual Orientation

Have you been in DCS custody in the past year?

Yes

No

If yes, when did you exit?

EDUCATIONAL INFORMATION

Are you currently enrolled in high school, college, vocational school, or training program?

Yes

No

If yes, name of school

Anticipated graduation year

EMPLOYMENT INFORMATION

Are you currently employed?

Yes

No

If yes, name of employer

MEDICAL INFORMATION

Are you currently taking or prescribed any medications?

Yes

No

If yes, describe

Do you have any allergies?

Yes

No

If yes, describe

Do you require special accommodations due to a medical or mental health diagnosis?

Yes

No

If yes, describe

Are you currently pregnant?

Yes

No

Do you have any children?

Yes

No

HISTORY

Do you have a history with any of the following:

Violence

Domestic Violence

Drug Use

Mental Health Diagnosis

Alcohol/Substance Abuse

Gang Affiliations

OTHER

Any additional information you feel we should know

REFERENCES

Please list three people who can provide a character reference and have informationabout your current living situation.

Name

Phone

Relationship

Name

Phone

Relationship

Name

Phone

Relationship

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145 Bear Crossing
Suite 100
Mt. Juliet, TN 37122

|

615-681-2960

Contact@thebridgehousetn.org

The Bridge House is a 501(c)(3) charitable organization.
EIN 84-3657259. All contributions are tax deductible.

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