Youth Interest Form

Thank you for your interest in the My First Place Program. At First Place in California, we provide transitional housing and support services for former foster youth and homeless youth ages 18 to 24. At First Place in Mississippi, we provide transitional housing and support services for former foster youth ages 18 to 21.

In order to direct your referral to the right staff member, please answer as many questions as possible on the following form. All information submitted by this form is confidential and only used to evaluate eligibility for our programs. Entry requirements vary by state and by county. Completing an interest form does not guarantee program entry.

My First Place Intake

First Place accepts direct inquiries from young people interested in our program, as well as referrals by a social worker, probation officer, or other provider or supporter. To begin a referral or inquiry, please tell us whether you are completing this form for yourself or on someone’s behalf.

Please provide your contact information and your relationship with the young person you are referring

In California, My First Place is open to young people between the ages of 18 and 24. In Mississippi, My First Place is open to young people between the ages of 18 and 21.
Identified Race/Ethnicity (Select as many as apply)
Identify placement state
For California, referred placement county
For California, identify any additional potential placement counties
Note: First Place primarily serves youth in foster care/juvenile justice and has limited space for those who have not been in either system.
Note: First Place is not an emergency housing program and cannot guarantee immediate placement for eligible youth.
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