GenNext Referral Form

Thank you for considering AGBU Generation Next as a collaborator to assist in your student's academic and personal growth journey. We look forward to working together to improve the lives of teens in the greater-Los Angeles area by matching them with mentors ready to be positive influences. 

Please take a moment to complete this referral form. Upon receipt, we will reach out to the parent or guardian named to introduce the program. We would appreciate if you would also take the time to inform him/her of your referral. Once a student is enrolled, we will work with you to discuss needs and progress. 

Kindly note that you must submit one form per student referral. Thank you.

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Referring Party Information

Family Information (email and phone number must be provided in order to contact the family)

Student Information

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