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P.O. Box 1746

Riverhead, NY 11901

Enrollment Application
Member of LGBTQ+ Community
Highest Grade Completed
Education Progrms Interests - Chec all that apply:
Physical/Learning Disability

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Sound Justice Initiative and its grant-funded education providers do not discriminate based on race, color, creed, national or ethnic origin, sexual orientation, gender, gender expression, religion, disability, age, political affiliation or belief, genetic information, veteran or citizenship status (except in those special circumstances permitted or mandated by law). Revised 02/01/24

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