We are happy to assist you if we can through our Neat Stuff Program. If you would like specific assistance with clothing, accessories, school items, baby items (e.g., diapers), or toys, please fill out the form below to get in touch with a Family Support Specialist.

If you are only interest in assistance through Neat Stuff at this time please indicate Select Value I am only interested in receiving assistance through the Neat Stuff Program at this time No, I do not need assistance at this time through the Neat Stuff Program I am interested in receiving assistance through Neat Stuff as well as additional services * Required

Are you a case manager making a request on behalf of a client Select Value Yes No * Required

If you heard about us from another program/organization, specify Select Value 211 (Switchboard) Family or friend Flyer I walked or drove by Internet MDCPS Referral - Attendance & Enrollment Program Newspaper Other Program at OYC Radio School Through my workplace Together for Children * Required

Parent First Name: * Required

Parent Last Name: * Required

Street Address: * Required

City: * Required

State: * Required

Zip: * Required

Cell Number: * Required

Parent Birth Day: * Required

Email: * Required

Password for future login: * Required

* Required

Can we reach you via text or email or both? Select Value Email Text/SMS Both * Required

Gender: Select Value Female Male Non-Binary Not Provided Transgender * Required

Primary Language: Select Value English Haitian-creole Spanish Arabic Ubo Yoruba Other * Required

Are you proficient in English? Select Value Yes No * Required

What is your marital status Select Value Single Married Divorced Domestic Partnership Seperated Widowed * Required

What is your annual income (estimated)? Select Value $4,999 or below $5,000 - $17,649 $17,650 - $26,999 $27,000 - $50,999 $51,000 or above I don't know * Required

Does your child(ren) receive free or reduced lunch at school? Select Value Yes No * Required

Have you or your family moved in the last 3 months? Select Value Yes No * Required

* Required

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Coaching Commitment Form

Coaching Session 1: Family Intake Survey (60 mins.)
Coaching Session 2: Family/Household Success plan (30-60 mins.)
Coaching Session 3: Follow-up (30 mins.)
Coaching Session 4: Follow-up (30 mins.)
Coaching Session 5: Follow-up (30 mins.)

Participation in this program will involve a Family Intake Meeting, creation of a Household Success Plan, and follow up meetings/communications throughout program participation.

To make sure your goals are clear and reachable, each one should be:

- Specific (simple, sensible, significant).
- Measurable (meaningful, motivating).
- Achievable (agreed, attainable).
- Relevant (reasonable, realistic and resourced, results-based).
- Time bound (time-based, time limited, time/cost limited, timely, time-sensitive).

When families commit to this process it is important to establish an ongoing relationship with the OYC staff and work as a team to keep up with strategies discussed in order to achieve personal and family goals. Families are encouraged to make a wholehearted commitment to this process and to make every effort to attend scheduled meetings (except for illness and emergencies).

Some families are referred to the EDEN Place Program from MDCPS as part of an Attendance and Engagement Initiative. The purpose of the OYC Attendance Initiative is to specifically support MDCPS students who are experiencing challenges with attending school on a regular basis and to identify potential resources for the student and family that will promote student engagement in school and increase supports for the family (as needed).

Coaching Commitment Agreement Select Value Accept - I accept these services and my family will participate in the OYC EDEN Place Program. I understand that I can discontinue program participation at any time. Accept - I would only like one-time assistance with information, referrals, and/or resources Decline - I decline these services and my family will not participate in the OYC EDEN Place Program. * Required

Coaching Commitment Agreement Date * Required

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Many parents/adults enjoy seeing pictures of their children or themselves in the newspaper, on television, or on social media; however, some parents/adults do not want their images shared publicly for various reasons. If you do not want yourself or your child photographed, the Overtown Youth Center (OYC Miami) will make an extra effort to see that you or your child is not available to public media sources. Realistically, all situations cannot be controlled, and OYC Miami cannot guarantee that an adult or child will not be identified in the public media reports, etc.

Please indicate your preference below:

Media Agreement: Select Value I DO NOT WANT my child to be photographed or interviewed for public media purposes. I DO WANT my child to be photographed or interviewed for public media purposes. * Required

Media Agreement Date: * Required

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OYC may use electronic systems (such as UniteUS) to submit referrals on behalf of clients to other community agencies or providers. Staff will share referral recommendations with clients prior to sending any information to another agency. Please indicate if you agree to have your information shared through this referral process.

Electronic Referral Agreement: Select Value I Agree I Do Not Agree * Required

Electronic Referral Agreement Date: * Required