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YC Application

Application MUST be filled out by student.

"*" indicates required fields

Step 1 of 5

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Student Information

Student Full Name*

Please put N/A if you do not have a middle name.

First Middle Last

Student Preferred Name/Nickname*

Birthday*

MM slash DD slash YYYY

Age*

Home Address*

Street Address Address Line 2 City State ZIP Code

Student Cell Phone (if you have one)

Student Email Address*

Student email only. NO school or Parent/Caregiver email.

Race/Ethnicity*

Please select all that apply.

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White or Caucasian

Gender*

Male

Female

Non-binary

My gender is not listed

Transportation*

I have reliable transportation to and from each session:

Yes

Physical Activities*

Is there any reason that you would be unable to be involved in activities such as a ropes course, community service projects or any other physical activity, either with or without accommodations?

Yes

Please explain*

How did you hear about Youth Corps?*

If any YC Students and/or YC Alumni referred you, please include their name.

Parent/Caregiver(s) Information

Parent/Caregiver Name*

First Last

Relationship to Student*

Parent/Caregiver's home address is…*

same as student’s

different than student’s

Parent/Caregiver Home Address*

Street Address Address Line 2 City State ZIP Code

Parent/Caregiver – Cell Phone*

Parent/Caregiver – Email Address*

Parent/Caregiver – Occupation and place of employment*

Do you have more than one parent/caregiver?*

Yes

Parent/Caregiver #2 Information

Parent/Caregiver 2 Name*

First Last

Parent/Caregiver 2 – Relationship to you*

Parent/Caregiver 2's home address is…*

same as student’s

different than student’s

Parent/Caregiver 2 – Home Address*

Street Address Address Line 2 City State ZIP Code

Parent/Caregiver 2 – Cell Phone*

Must be different than first Parent/Caregiver’s cell phone

Parent/Caregiver 2 – Email Address*

Must be different than first Parent/Caregiver’s email

Parent/Caregiver #2 – Occupation and place of employment*

School Information

Current School*

Current Grade*

8th

9th

10th

School you plan to attend in Fall 2024*

Current Grade Point Average*

Most Recent Report Card*

Max. file size: 1 MB.

Organizations & Activities

Please list up to five school, volunteer, religious, social, athletic, or other activities/organizations in which you've participated.*

(Include organization or activity; your grade in school at the time; brief description of your role.)

Work Experience

List any job experience, paid or volunteer, and briefly explain what it involved:*

Do you currently have a job?*

Yes

How many hours per week?*

Would your job interfere with the Youth Corps program?*

Yes

YC Questionnaire

Who is your hero or heroine (someone you admire)? Why?*

What are your hobbies and interests?*

Please explain what you hope to gain by participating in Youth Corps.*

What are your long-term and career goals?*

What do you think are the 3 best things about your hometown and why?*

Identify the 3 most significant problems facing Richland & Lexington Counties and describe your solutions.*

To complete your application:

Please list the name of one person whom you have asked to be a reference for you (other than a parent, friend, or relative). We will email your reference a link to the Reference Form. Your application is NOT COMPLETE until we have received a completed Reference Form.

Name of Reference:*

Prefix First Last

How does this person/reference know you?*

Reference Phone*

Reference Email*

We will email your reference a direct link to the Reference Form.

I understand that my Youth Corps Application is INCOMPLETE and I will not be scheduled to interview until my reference has submitted a Reference Form on my behalf.*

Yes, I understand.

BY TYPING IN MY NAME BELOW, I AM DECLARING THAT I AM THE PERSON WHO FILLED OUT THIS APPLICATION.*

First Last

Unleash your Potential

Apply Today

"Youth Corps has unlocked and unleashed in me what it takes to not only be successful, but to lead others to success as well."

- Cleveland, Youth Corps Class of 2011

"I've learned invaluable skills such as networking, time management, problem solving, and investment techniques."

- Chris C, Youth Corps Class of 2006

"My experience with Youth Corps can be summed up in one word… Unforgettable."

- K. Yeh, Youth Corps Alumnus

"I have become more outgoing and confident in myself as well as my abilities, all within the span of two days!"

- Gabby Y, Youth Corps Class of 2013

"Looking back, my life has made a complete 180 and it began to make that transformation when I was accepted into Youth Corps."

- Daisy B, Youth Corps Class of 2008

Apply

Contribute

info@youthcorps.net

803-587-9162

P.O. Box 211126 Columbia, SC 29221

P.O. Box 211126
Columbia, SC 29221

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