Youth Conservation Corps Member Application YCC Member Application [NEW] * Are you a resident of Lake County, Illinois, 16-24 years old and are interested in participating in this 6-12 month workforce readiness program? * Yes, I am Have you received a high school diploma? * Yes No If you have not yet graduated High School you are eligible for YCC's YouthBuild Waukegan program that include GED instruction. If you have graduated High School, you may choose either YCC YouthBuild Waukegan OR YCC Urban and Community Forestry program. Which of these paths sound appealing to you? You can choose one or both options. * YouthBuild - Construction and IT Urban Forestry (Must have graduated high school) Your First Name * Your Last Name * Email Address * Mobile Phone Number * Home Phone Number * Address * City, State, Zip * Date of Birth (MM/DD/YYYY) Example: 01/01/2000 Sex * Male Female Do you have a valid Social Security Number (SSN)? * Yes No Do you currently receive any government assistance? Yes No If yes, what kind (i.e. housing, food stamps, etc)? What type of housing best applies to you? * House Apartment Public Housing Halfway House Homeless Shelter Group Home Other Who do you live with? Parents Other Family Alone Roommates Spouse/Partner Race/Ethnicity Black / African American Hispanic / Latino White / Caucasian Native American Other Last School Attended Last Grade Attended 7th Grade8th Grade9th Freshman10th Sophomore11th Junior12th Senior Last Year Attended 202120202019201820172016201520142013201220112010 If you didn't finish high school, why not? Have you completed the GED Program? * Yes No If no, what GED tests have you completed? Have you held a job before? * Yes No Are you currently working? * Yes No If yes, hourly rate? If yes, hours per week? Name of Company Job Title Are you now on probation * Yes No If yes, what is your Probation Officer's name? If yes, what is your Probation Officer's phone number? Are you currently on parole? * Yes No If yes, what is your Parole Officer's name? If yes, what is your Parole Officer's phone number? If any, please list scheduled or pending courts dates What is the size of your household (the number of persons currently living together in your home, including yourself ) * What is your estimated annual household income? $0-$13,400$13,400-$26,80026,900-$40,210$40,210-$53,620$53,620-$67,020$67,020+ I certify that the above information is true and correct to the best of my knowledge. * Yes Do you have a current driver’s license, state-issued ID card (not high school) or passport? * Yes No What is the expiration date of your identification (month/day/year)? How did hear about YCC? * YCC Website Current or Past YCC Member Social Media Flyer, postcard, or sign. YCC Van Counselor or Probation Officer Other If you answered friend or family member above, who referred you to YCC? Captcha Submit If you are human, leave this field blank.
