Interest Form

If you or someone you know would like to join our programs, please complete the form below. After you complete the form, a member of our staff will be in touch with you. Completion of this form does not guarantee you a spot, but we will add you to our waiting list if you are interested. If you would like more details about our programs, reach out to info@nbreentry.org or click on the "programs" tab on our website.

Applicant's Preferred First Name*

Applicant's Last Name*

Applicant's Pronouns

What is the applicant's gender?

What is the applicant's racial / ethnic identity?

Is the applicant formerly incarcerated?*

Applicant's Email*

Applicant's Phone Number*

Is someone other than the applicant filling out this form?*

If the answer is yes, what is your relationship to the applicant?*

Full Name*

Phone Number*

Email*

What is your reason for referring the applicant to our programming?*

Programs of Interest (select all that apply)*

Yoga (Summer)

Financial Literacy (Summer)

The Bridge Project (Summer)

Restorative Justice (Summer)

Coping Skills & Sound Healing (Summer)

Anger Management (Summer)

Individual Counseling (Ongoing)

Visual Art Studio (Summer)

Group Substance Use Counseling (Ongoing)

Culinary Arts & ServSafe (Fall)

How did you hear about New Beginnings Reentry Services?*

Facebook

Instagram

Newsletter

Website

Family / Friend

Community Organization

Case Manager / Social Worker

Parole Officer / Court Referral

Other

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Contact

(781) 807-1741 | info@nbreentry.org
36 Gaston Street | Dorchester, MA 02121
Hours: Monday–Thursday 11am–4pm

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Interest Form

(781) 807-1741 | info@nbreentry.org 36 Gaston Street | Dorchester, MA 02121 Hours: Monday–Thursday 11am–4pm

©2025 New Beginnings Reentry Services | All rights reserved.

(781) 807-1741 | info@nbreentry.org
36 Gaston Street | Dorchester, MA 02121
Hours: Monday–Thursday 11am–4pm