BSCC Grant Participant Sign in

BSCC Grant Participant Sign in

BSCC Grant Participant Sign in form 2022

Were you referred to this program?(Required)
Referred meaning "mandated" or voluntary.
Is this your first, second or third time enrolling into this program?(Required)
Which age group do you belong to?(Required)
Which gender do you identify as?(Required)
What is your race/ ethnicity?(Required)
Are you currently enrolled in an education program?(Required)
If you are not currently enrolled in an education program, do any of the following apply to you?(Required)

What is your current employment status?(Required)
If you were recently incarcerated, how long has it been since your release from an institution?(Required)
Are you currently engaged in any of the following activities or receiving any of the following services? (Check all that apply)(Required)
Which site or chapter are you attending?
MM slash DD slash YYYY


Exit questionnaire for BSCC participants

Did you complete the Phoenix program?(Required)
Do you feel more prepared to leave your current environment than you did at the start of the program?(Required)
Has the Phoenix program encouraged you to seek employment or job training in the near future?(Required)