From Locked Up to Level Up — Program Application

01 Personal Information

First Name *

Last Name *

Date of Birth *

Age

Phone Number *

Email Address

City & State *

How Did You Hear About Us?

If referred — who referred you?

02 Current Status

Current Situation *

Time Since Release / On Supervision

Current Employment Status

Highest Education Level

Do you have any immediate needs we should be aware of? (housing, transportation, childcare, etc.)

03 Select Your Track

Both tracks include all 6 core modules. Select the track that best aligns with your primary goal right now.

🏢

Employment Track

I want to access a high-demand career position and stable employment.

💼

Entrepreneur Track

I want to build my own business and become an entrepreneur.

Not sure which track is right for you?

04 Your Goals & Background

What areas do you most need support in? Select all that apply.

Resume building Interview preparation Business structure Financial literacy Budgeting & saving Mindset & personal development Life skills Workforce funding access

What is your primary goal right now? Tell us in your own words.

What has been your biggest challenge since your release or while on supervision?

Do you have any work skills or experience?

Do you have a business idea in mind?

Is there anything else about your background or situation you'd like us to know?

05 Youth Applicants (Under 18)

For applicants under 18 years old only. If you are 18 or older, you may skip this section. All youth participants require parental or guardian consent to enroll in the program.

Parent / Guardian Name

Parent / Guardian Phone

Parent / Guardian Relationship to Applicant

Is the youth currently enrolled in school?

06 Scholarship & Financial Assistance

No one will be turned away due to inability to pay. Scholarships are available and are awarded based on need and availability of funds. Being honest here helps us serve you better. All financial information is kept strictly confidential.

Are you able to pay the program fee?

Are you currently receiving any public assistance?

Is there anything additional you'd like us to know about your financial situation?

07 Your Commitment

By submitting this application, you acknowledge that From Locked Up to Level Up is a personal development program operated under DAAT Blueprint. All information shared is kept strictly confidential and will not be shared with probation, parole, or any legal authorities. This program is a voluntary support resource. Results depend on your participation and commitment.

I confirm that all information provided in this application is accurate and truthful to the best of my knowledge. I understand that my results depend on my commitment, participation, and follow-through with the full 90-day program and monthly check-ins. I understand that scholarship awards are based on need and fund availability, and that program fees are due before the start of my program unless a scholarship is confirmed in writing. I am ready to invest in my future and take the next step toward the life I deserve.

Anything else you'd like us to know before your intake call?

We will reach out within 1–3 business days to schedule your intake call. 🕊️

Application Received

Thank you for taking this powerful step.
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Your past got you here. Your future starts now. ✦