For Teachers

Do you have a student in your classroom who would benefit from the YouthBASE program?

  • Fill out the referral form. YouthBASE staff will contact you within 2 days upon receiving the information.
  • Please contact the child’s parent and tell them that you have referred their child to YouthBASE. You may send a child application form home after speaking to YouthBASE staff.
  • Parents are asked to bring the application to YouthBASE to meet our staff and attend a parent meeting.
  • Upon enrollment, parent will notify school of transportation change.
  • Call or email if you have any questions. ltassie@youthbase.org

We want to partner with you. Staff will communicate with you to assess progress or needs, attain reading levels (quarterly), ask you to fill out a survey. Please do not hesitate to contact us if there is a way that we can support you. We appreciate all that you do!

Child Application

Download & Print

K5 Enrollment Referral Form

Complete form below

Or Download & Print

1st Grade Enrollment Referral Form

Complete form below

Or Download & Print

Contact Us

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