Donate
Ranch Videos
Gallery
Instagram Feed
Facebook Feed
Graduates
Inspirational
Contact
About
Application for admittance
*
Indicates required field
Your Name and Address
*
Line 1
Line 2
City
State
Zip Code
Country
Your Phone Number
*
Your Email
*
Parent's Name and Address
*
Line 1
Line 2
City
State
Zip Code
Country
This information is optional
Parent's Phone Number
*
This information is optional
How did you hear about The Ranch?
*
Internet Search
Advertisement
Friend
Other
If Other, please specify:
*
What is your age?
*
18
19-25
26-35
36-50
Over 50
What is your household income?
*
Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
Other income?
*
Disability
SSI
Foodstamps
None
What type of insurance do you have?
*
Medi-Cal/Medicare
Your own insurance
None
Why do you want to be a Rancher?
*
Are you currently using drugs or alcohol? (describe)
*
Have you ever been convicted of a crime? (describe)
*
Submit
Donate
Ranch Videos
Gallery
Instagram Feed
Facebook Feed
Graduates
Inspirational
Contact
About
