OATHS Assistance Application

OATHS is a non-profit organization founded by a student to help homeless students get what they need to enjoy, succeed, and stay in school. Please fill out the following form so we can help you.

Please fill out the form below to apply online, or if you prefer to download a printable application for to fill out and mail in, you can do so here.

Information Form

Your Name:(required)
School:(required)
Grade Level:(required)
School Contact (Counselor or Social Worker):(required)
Date of Birth:(required)
1. What is your current living situation?
2. What goods and services do you need to make the most of your educational experience in the areas of academics, athletics, music, or extracurricular activities?
3. What else can we do to help you enjoy your time in school?
4. How can we help you achieve your academic goals?
5. Are you interested in being mentored or tutored by a high school student?
Yes No
6. Are you interested in receiving a free membership at the YMCA?
Yes No
7. May we have your permission to use your name and/or photograph as someone we have helped through our organization?
Yes No

Parent / Guardian / Primary Contact Information

Name:(required)
Email:(valid email required)
Phone #:(required)
Mailing Address:(required)
Digital Signature (type full name):(required)
Date:(required)