If you would like to enroll your child into Teens Strait Media Solutions please fill out the form below and we will send the Registration Form for you to fill out sign and send back to us.



Please fill in your full name your address, date of birth and your legal parenting status.

Name: Last, First, MI
 
Please select one:
   
 
Son/Daughters Name
 
Address:
 
Phone:
 
Cell Phone:
 
Email Address:
 
How did you hear about us?
 
Does your teen display a keen eye for detail and a critical mind?
   
 
Is your teen creative and have a passionate interest in film and video editing?
   
 
Does your teen lack self-esteem and self-worth?
   
 
Does your teen display patience and concentration while watching a movie?
   
 
Does your teen have the ability to listen to others and to work well as part of a team?
   
 
Does your teen display a high level of self-motivation, commitment and dedication?
   
 
Do you worry your teen may not finish high school?
   
 
Does your teen display organizational and time management skills at home or at school?
   
 
Does your teen seem unmotivated or depressed at times?
   
 
Does your teen display any strong interpersonal skills to work well with other students?
   
 
Does your teen display the ability to work under pressure and to meet deadlines?
   
 
Do you worry about your teen’s future?
   
 
Despite rules and consequences, do you feel your teen will defy them?
   
 
Does your teen display communication skills, both written and oral at home and at school?
   
 
Have your teen ever displayed a commitment to high-quality work regardless of what it is?
   
 
Does your teen have the ability to work alone on detailed and sometimes tedious work?
   
 

Teens Strait Media Solutions: serves as an intervention program for teens identified as at risk for academic failure due to defiant or destructive behavior, substance abuse issues, and potential judicial interaction. Our goal is help students ages 13-18 learn a trade or become college-ready. UBM will provide teens that qualify for the program with the Adobe Master Collection Software using Adobe’s online professional instructors. As a result of this program students will become mentally healthier with better self-management skills, communication skills, and academically prepared to pursue a professional trade or to pursue a college career.

Parent/Legal Guardian E-Signatues

 
Date