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Foster Youth Aging Out
Intake Form

If you are between the ages of 17 and 21 and aging out of foster, then you are in the right place.
This intake form helps us learn more about you and the kind of support you’re looking for. Lott Legacy is here to provide access to resources, guidance, and creative support for young people transitioning out of foster care. There are no right or wrong answers—just be honest and share what you’re comfortable with.

Everything you share is kept confidential and used only to help us connect you with the right opportunities and services. Once you complete the form, a member of our team will follow up with next steps. You don’t have to do this alone, we’re here to support you as you move forward.

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Lott Legacy Foster Youth Intake Form

Middle Name

Preferred Name (if different)

Birthday
Month
Day
Year

What is your preferred method of contact?

Multi choice

Foster Care Background

What is your current status?

Multi choice

What is your employment status?

Multi choice

How Can We Support You?

  1. What type of support are you interested in?

    (Select all that apply)

Multi choice

Tell Us More

  1. What are you most concerned about right now?

Is there anything else you’d like us to know about your situation or goals?

Consent & Next Steps

Consent to Contact

Thank you for reaching out.

Taking this step matters. A member of our team will follow up with you soon to talk through next steps and connect you with the right support. You are not alone and there is help available.

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