Participant Application

Thank you for your interest in the Brazen Table virtual program. Please fill in the application below. We look forward to hearing from you and will be in touch soon. If you have been referred by another organization, please be sure that organization has also filled out a Referral Form on your behalf.

Brazen Table - Foundations Participant Application

Program Details

What you get

An 6-week interactive hands on experience
All work materials are provided
$200 Weekly Stipend
Employability Skills
Personal Development
Food Handler’s Certification
1-on- 1 Case Management

Emergency Contact

This should not be your case manager.

Name *

Phone Number *

Relationship *

Alternate Phone Number

Are there additional services you would find helpful?

Programmatic Questions

You should expect to spend 18 hours a week for 6 weeks to complete the program. If you have any children or others that you are responsible for their care, how do you plan to balance the workload for this program while caring for them?

If you are currently employed, how do you plan to balance the workload for this program while working?

Personal Goals + Expectations

Why do you want to participate in Brazen Table: Foundations? *

What do you expect from participating in Brazen Table: Foundations? *

What are your personal strengths? (Examples: detail-oriented, loving, compassionate, etc.) *

What questions do you have before starting the program?

What else would you like for us to know about you?

How did you hear about Brazen Table?

Foundations Program

Participant Application

Program Details

General Information

Emergency Contact

Referral Agency

Housing + Access

Programmatic Questions

Personal Goals + Expectations

Location

Address

Hours

Phone Number

Keep In Touch