In-Kind Donation Contribution Form YCC Guest Speaker Form YCC empowers and mentors young adults, ages 16-24, to succeed through education and training in life skills, career pathways, and environmental stewardship. We offer three programs: a two-month summer conservation program, a six-month YouthBuild program, and a four-month Graduate program. Contributor's Information *NOTE: This is a contribution of your time. Name of Business or Individual * Name of Primary Contact * Address * City, State, Zip * Phone * Email * Contributed Goods or Services * Guest Speaker Mock Interview Date(s) of Contribution * Total Hours Contributed * Real or Estimated Value of Your TIme * How was the value determined * Actual Appraisal Who made this value determination? * Are there restrictions on this contribution? * Yes No If yes, explain the restrictions. Was this contribution obtained with or supported by Federal Funds? * Yes No If yes, please provide the name of the Federal agency and the grant or the contact number. By signing this form, I consent to have my photo, quotes and stories used on behalf of YouthBuild and AmeriCorps in publications, promotional items, media relations and on the Web site. If possible, I would like to receive copies of documents that have media related to me in them. * Yes No Signature * Date * If you are human, leave this field blank. Submit
