Impact Teens iFAM Connection Form

Here's your chance to become an iFAM member of Impact Teens Goldsboro. You have the opportunity to be apart of our Goldsboro iFAM with the hopes to continue to make a major impact in our community.

Simply fill out the connection form below and we will get in contact with you to let you know the next steps. If you have any questions feel free to send us an email at or give us a call at (984)277-0071.

Make a difference in our city by joining one of the best youth-led organizations in Wayne County.

Impact Teens Goldsboro works hard to provide several events, programs, and community service projects for teens and our community members to be involved in. With service, mentorship, leadership, and innovation under our belt, we would love to have you join our organization.

To be a member of Impact Teens Goldsboro you must be a teen between the ages 10 and 23 and live in Wayne County. All members are expected to be actively involved in all organizational activities and to serve as a positive leader for teens in our community. #More
First Name *
Last Name *
Birth Date *
Address *
Email Address *
Phone Number *
Grade Level *
School Attending (If Applicable) *
Parent or Emergency Contact First & Last Name *
Parent or Emergency Contact Phone Number *
Parent or Emergency Contact Email Address *
Why do you want to join the iFAM? *
What does making an IMPACT mean to you? *
What does being a leader mean to you? *
What other extra-curricular activities are you involved in? (List school clubs, church groups, sports teams, jobs, etc.) *
How did you hear about Impact Teens? *
By submitting this application, you acknowledge that you have permission from your parent or legal guardian to join Impact Teens. *
Impact Teens' iFAM members are expected to be role-models of our community. By completing this application, you agree to attend all meetings and events, and to uphold the standards, conduct, and responsibilities within the Impact Teens organization. *
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