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2025 IBT Application
Thank you for your interest in joining GRID Alternatives'
IBT Program
.
If you haven't already, please click here to view this
Informational Slideshow
before continuing with the application.
Please fill out this application in full. A team member will contact you within the next 1-2 weeks
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to save your progress.
Learn more
* Indicates required question
First Name/ Nombre
*
Your answer
Last Name/ Apellido
*
Your answer
Sex/Sexo
*
Male/ Masculino
Female/ Feminina
Gender/género
*
Choose
Male - Hombre
Female - Mujer
Transgender - Transgénero
Agender - Agénero
Aliagender - Aliagénero
Androgyne - Andrógino
Bigender - Bigénero
Cisgender - Cisgénero
Prefer Not to Disclose - Prefiere No Revelar
Other - Otro
How do you self-identify? (Please select one response) /
¿Cómo te identificas? (Selecciona una respuesta):
*
Choose
Bi-Sexual - Bisexual
Gay - Gay
Lesbian - Lesbiana
Queer/Questioning - Queer/Cuestionando
Straight - Heterosexual
Prefer not to disclose - Prefiero no revelar
Birthdate/
fecha de nacimiento
*
MM
/
DD
/
YYYY
Email Address/
dirección de correo electrónico
*
Your answer
Phone Number/
número de teléfono
*
Your answer
What are the last four digits of your SSN?
*
Your answer
Street Address/
dirección postal
*
Please enter your residential address for eligibility purposes.
Your answer
City
*
Your answer
Zip Code/
código postal
*
Your answer
If you were referred by anyone please provide their name here:
*
Your answer
What is your housing status? Que es tu
estado de vivienda?
*
Subsidized housing/ vivienda subsidiada
Permanent supportive housing/ vivienda con apoyo permanente
Transitional housing/ vivienda de trasicion
Shelter/ refugio
Halfway house/ casa de medio camino
Couch surfing or staying at someone else's house (parents, friends, family)/ Sofá-surfing o quedarse en la casa de otra persona (padres, amigos, familia)
Formerly homeless/ Anteriormente sin hogar
Currently unhoused/ Actualmente sin vivienda
Rapid rehousing/ Realojo rápido
Renter/ Lessee (in your own name)/ Inquilino/Arrendatario (a nombre propio)
Homeowner/ Propietario de vivienda
Have you or anyone in your immediate family been impacted by the criminal justice system?/
¿Usted o alguien de su familia inmediata ha sido afectado por el sistema de justicia penal?
*
*We have some programs that support people impacted by the criminal justice system. This question is not a disqualifier. /
Tenemos algunos programas que apoyan a las personas afectadas por el sistema de justicia penal.
Esta pregunta no es un descalificador.
Yes
No
If you answered "yes" to the question above, please explain./
Si respondió 'sí' a la pregunta anterior, por favor explique
Your answer
Have you or your spouse ever served in the military? /¿Has servido tú o tu cónyuge en las fuerzas armadas?
*
Yes
No
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