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Phoenix Rising Teen Development provides mentoring, work ethic development training, trauma informed job placement services, job hunting training, and pro-social community based activities. Click here to add your own text and edit me. This is a place for you to learn more about our mission and how we can support your teen.

New Particpant Registration

All information provided will be kept confidential. 

Please fill out the form below to refer yourself or a teenager you know to Phoenix Rising Teen Development. 

The following 3 questions determine eligibility for services.   Check each box below to answer yes.   If you have any more questions about eligibility, then please use the contact information at the bottom of the form.  

Please continue to fill out the form below if you answered yes to the 3 questions above. 

Other risk factors. Please check all that apply.

Please list the adverse childhood experiences that the person being referred has experienced.  This helps determine Medicaid eligibility. 

Does the person being referred have any known disabilities?
Does the person being referred have any allergies?
Is the person being referred on any medications?
Looking back over the last year of school what is the ballpark GPA that the person being referred maintained?
General employment questions. Check all boxes where the answer is "yes".

Thank you for your referral. We will get back to you within 2 business days.

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Contact Info:    
E-mail:  contact@prtd.org             

Phone:  719-425-5421

Physical Program Address:  1804 Francis Place, 80909

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