Capital Region Youth Intake
  • Are you legally authorized to work in the United States or a US citizen?*
  • Are you currently attending any school?*
  • Does anyone in your household receive SNAP (Food Stamps), TANF (Cash Assistance), or SSI/SSDI?*
  • Select all that apply:*

  • Include yourself and anyone you live with who shares income or expenses (such as a parent, guardian, or spouse).

  • Household size Annual Limit Monthly Threshold
    1 $15,960 ~$1,330
  • Household size Annual Limit Monthly Threshold
    2 $21,640 ~$1,803
  • Household size Annual Limit Monthly Threshold
    3 $27,448 ~$2,290
  • Household size Annual Limit Monthly Threshold
    4 $33,888 ~$2,825
  • Household size Annual Limit Monthly Threshold
    5 $39,995 ~$3,330
  • Household size Annual Limit Monthly Threshold
    6 $46,777 ~$3,900
  • Household size Annual Limit Monthly Threshold
    7 $53,559 ~$4,465
  • Household size Annual Limit Monthly Threshold
    8 $60,341 ~$5,030
  • Is your total household income at or below the amount shown above? Include income from all household members before taxes (wages, benefits, etc.). If you’re not sure, select “I’m not sure”—we’ll help you figure it out.*

  • The following questions lets us know if you meet one of our priority populations and does not automatically disqualify you from the program.

  • Did you drop out of school?*
  • Do you lack a high school diploma or equivalent?*
  • Are you homeless or runaway?*
  • Are you involved in the foster care system or aged out?*
  • Are you pregnant or parenting?*
  • Have you been involved with the justice system (which includes ever being arrested; incarcerated in jail, a detention center, or prison; or on probation or parole)?*
  • Is english your second language?*
  • Are you at risk of dropping out of school?*
  • Do you require additional assistance to complete education or secure employment?*
  • Are you currently working?*
  • Should be Empty: