"I've done so many things that I never imagined I would do. From jumping off of a telephone pole to nailing shingles on a roof, Youth Corps has truly pushed me out of my comfort zone. And I'm glad! I'm taking more risks to better myself than I ever thought possible. And Youth Corps has helped me achieve this."
- G. Baker
Youth Corps Alumnus

"Youth Corps students are some of the most amazing students you will meet anywhere."
- Jeff Becraft
Youth Corps Executive Director

Youth Corps Nomination Form

Please use this page again for each student you wish to nominate.

When you click on each field for new entries, the form should automatically fill in the previously used values, saving you some time. We will keep all information you give us private and only for our use.

NOTE: If you need a PDF version of the form which you can print out and mail or fax to us, please Contact Us and we will mail or email a form to you.

Let's get started. Please give us your information.

First Name*
Last Name*
Zip Code

Please give us the Student Nominee's information.
Student First Name*
Student Last Name*
Gender* Male
8th Grade
9th Grade
Student Address*
Student City*
Student State*
Student Zip*
Student Phone
Student Email
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