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Board of Directors
Partners & Sponsors
E-Newsletter
Our Programs
YouthBuild
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YCC Guest Speaker
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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]
* 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 Grade
8th Grade
9th Freshman
10th Sophomore
11th Junior
12th Senior
Last Year Attended
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
If you didn't finish high school, why not?
Have you completed the GED Program?
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Yes
No
If no, what GED tests have you completed?
Have you held a job before?
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Yes
No
Are you currently working?
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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-$26,800
26,900-$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.