top of page

CREATING A BRIGHTER FUTURE - P: (786)600-9029

MEYGA Learning Center Institute
Parent Resources
After School
- After School Programs
- Registration
Youth Development Program
- Summer Programs
- Form to Summer Programs
Resource Hub
About
Contact

Resource Hub

MEYGA SOLUTIONS ONE-STOP RESOURCE HUB
CLIENT INTAKE FORM

DISCLAIMER: Thank you for your interest in being a client of MEYGA SOLUTIONS ONE-STOP RESOURCE HUB. This form is used to collect information about new clients for internal purposes only and to be kept confidential.

Personal Information

First name*

Last name*

Multi-line address

Country/Region*

Address*

Address - line 2*

City*

Zip / Postal code*

Email*

Phone

Service Request Information

Referrals for Housing

Job Readiness

Job Placement

Case Management

Parent Enrichment

Technology Training

Private School

Afterschool Care

Summer Camp

Field Trips

Out-source to Hub Partners

Credit Repair

Final Eviction

Entrepreneurship/ Trade Skills

First-time Ownership

Immigration

Individual/ Group Therapy

Homelessness

Legal Service

Financial Literacy

Annual Final Notice Service

Electricity Bill$

Water Bill$

Security Deposit$

Signature

Signature*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date *

OFFICIAL USE ONLY

Single choice

Approved/Amount

Denied Reason

Director Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

MENTORING EMPOWERING YOUTH GLOBAL ACHIEVEMENT

HOURS OF OPERATION

8 AM - 6 PM

MONDAY-FRIDAY

1466 NW 62 St.

Miami, FL 33147

INFO@MEYGA.ORG

CALL NOW

P:: (786)600-9029

MEYGA Learning Center Institute
Parent Resources
After School
- After School Programs
- Registration
Youth Development Program
- Summer Programs
- Form to Summer Programs
Resource Hub
About
Contact

bottom of page