Enroll today

Who is completing this application?*
- Myself
- Guardian
- Other (write in)
Who is completing this application? Write in
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Living Status*
- Independent House or Apartment
- Group Home
- With parents or guardians
- Other (write in)
Living Status (write in)
Are you your own legal guardian?*
- Yes
- No
- Unsure
Phone*
Email*
Date of birth*
MM slash DD slash YYYY
Gender*
- Male
- Female
- Trans Male
- Trans Female
- Gender Queer/Nonbinary
- Other (write in)
Gender (write in)
Sexuality
- Straight
- Gay
- Lesbian
- Bisexual
- Queer
- Pansexual
- Asexual
- None
- Other: Write In
Sexuality (write in)
Race/Ethnicity*
- American Indian or Alaskan Native
- Asian Indian
- Black or African American
- Chamorro
- Chinese
- Filipino
- Hispanic – Cuban
- Hispanic – Mexican, Mexican American or Chicano
- Hispanic – Other Latine/LatinX or Spanish Origin
- Hispanic – Puerto Rican
- Japanese
- Korean
- Middle Eastern or North African
- Native Hawaiian
- Other Asian
- Other Pacific Islander
- Prefer Not to Say
- Samoan
- White or Caucasian
- Other: Write In
Race/Ethnicity (write in)
Religious Identity*
- Atheist
- Baptist
- Buddhist
- Catholic
- Christian
- Episcopalian
- Hindu
- Jewish
- Jewish Conservative
- Jewish Orthodox
- Jewish Reformed
- Lutheran
- Muslim
- No Preference
- Protestant
- Unitarian Unspecified
- Other: Write In
Religious Identity (write in)
Disability Type. Please select all that apply.*
- Anxiety
- Autism Spectrum
- Blind/Low Vision
- Cognitive
- Depression
- Emotional/Behavioral
- Hard of Hearing
- Intellectual
- Learning
- Mental Illness
- Physical
- Traumatic Brain Injury
- Other: Write in
Disability Type (write in)
How do you communicate with people?*
- Verbally
- American Sign Language
- Video remote interpreting
- Notetakers
- Large print materials
- Captioning
- Accessible electronic and information technology
- Other: Write In
How do you communicate with people? (write in)
Please select all that apply to you*
- I need assistance with eating meals.
- I do NOT need assistance with eating meals.
- I need assistance with using the restroom.
- I do NOT need assistance with using the restroom.
- I have been hospitalized in the past year for a physical condition such as surgery or an accident.
- I have been hospitalized in the past year due to psychiatric or mental health reasons.
- I have NOT been hospitalized for any reason in the past year.
Please select any of the following assistive means you use to help with mobility. Please select all that apply*
- Wheelchair
- Walkers
- Canes
- Crutches
- Scooter or Electric Wheelchair
- Service Animal
- Other: Type In
- I do NOT use any assistive mobility device.
How do you get to events you want to go to? Please check all that apply*
- Uber/Lyft
- The Ride
- MBTA (Train or Bus)
- Parents
- Group Home Transportation
- Walk
- Bike
- Other: Write In.
How do you get to events you want to go to? (write in)
Which version of the Friend 2 Friend program are you more interested in?
- MAGIC
- Community
- I am interested in both programs.

Participant Enrollment Form