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YCC Tour
Our Programs
YouthBuild
Summer Program
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Events
Rockegan
Golf Outing
Build+Brews+Bears
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YCC Member Application
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YCC Member Application
Youth Conservation Corps Member Application
YCC Member Application [NEW]
Basic Eligibility
Do you live in Lake County, Illinois?
*
Yes
No
Are you between the ages of 16 and 24?
*
Yes
No
Can you commit to a 6-to-9-month program, followed by 12 months of follow-up support?
*
Yes
No
Personal Information
Legal First Name
*
Preferred First Name
Last Name
*
Email Address
*
Mobile Phone Number
*
Alternate Phone Number
(parent, guardian, sibling, or other contact)
Preferred Method of Contact
*
Email
Text/Call Mobile Phone
Text/Call Alternate Phone
Other
Other
Address
*
City, State, Zip
*
Date of Birth (MM/DD/YYYY)
*
Example: 01/01/2000
Race/Ethnicity
Asian
Black / African American
Hispanic / Latino
White / Caucasian
Native American
Two or more races
Other
Other
Housing and Household
Which type of housing best describes your current living situation?
*
House
Apartment
Public Housing
Halfway House
Homeless Shelter
Group Home
Other
Other
Who currently lives with you? Please check all that apply.
*
Parent(s)
Grandparent(s)
Sibling(s)
Other Family
Roommate(s)
Spouse/Partner
I don't live with anyone else
How many people currently live in your household, including you?
*
What is your estimated annual household income?
*
$0-$13,400
$13,400-$26,800
$26,900-$40,210
$40,210-$53,620
$53,620-$67,020
$67,020+
Education
Have you earned a high school diploma or GED?
*
Yes
No
Last School Attended
*
Last Grade Completed
*
12th - Senior (Graduated)
11th - Junior
10th - Sophomore
9th - Freshman
8th Grade
7th Grade
Other
Last Year Attended
*
If you did not finish high school, briefly explain why.
Employment
Have you held a job before?
*
Yes
No
Are you currently working?
*
Yes
No
If yes, what is your hourly pay rate?
If yes, how many hours do you work per week?
If yes, what company do you work at?
If yes, what is your job title?
Documentation
Which documents do you have? Select all that apply.
*
Valid driver's license
Valid state-issued ID (excluding high school IDs)
Valid passport
Original Social Security card (official document; copies are not accepted)
Original birth certificate (official document; copies are not accepted)
Public or private health insurance card
Referral Information
How did you hear about YCC and YouthBuild Waukegan?
*
Family Member or Friend
Current or Past YCC Member
Social Media
YCC Website
Counselor, Teacher, or Staff Member
Flyer, Postcard, or Sign
YCC Van
Probation or Parole Officer
Other
Other
If you selected “Family Member or Friend” or “Current or Past YCC Member” above, what is their name?
Next Steps
By selecting “Yes,” I certify that the information provided in this application is true and correct to the best of my knowledge.
*
Yes
After you submit your application, we will contact you to schedule an in-person interview. During the interview, you will learn more about Mental Toughness, a one- to two-week orientation, and whether you have been invited to participate.
Submit
If you are human, leave this field blank.