2024-2025 AHA! Santa Barbara Youth Program Application

Please complete this application as a first step toward enrolling your teen in AHA!.

Please submit only one application per teen per termOnce enrolled, if you would like to add additional groups/programs, please contact Enrollment Operations Specialist, Paulina Romero, via email at paulina@ahasb.org, or text at (805) 229-1079
Student Information

Parent/Guardian Information

Note: Email Address provided above will receive confirmation email.
Parent/Guardian Address Information (if different from student address above) 

Parent Survey

Referral Information

School Information

Emergency Contact Information

What Programs Are You Interested in Participating In?
Group options that appear below are dependent on grade level selected.

We require that all families enrolling teens in our programs make a donation toward the cost of delivering those programs. 

It is vital that we receive a donation from every family enrolling, even if it is a small one! 

Donations can be made at the time of application or upon confirmed placement in an AHA! group. 

Please donate whatever your finances allow by sending a check (made out to AHA!) to our physical address (1209 De La Vina St. Suite A, Santa Barbara, CA, 93101), by using the “Donate” button at this website or via Venmo @AHA-SB-1.

Donations are not refundable.  

Please add a note to any online donation indicating that it is a donation. 
If your family is unable to donate, please contact Executive Director, Roxana Petty at roxy.ahasb@gmail.com