Youth Corps 2017 9-week Internship Application
Email address
Your full name
Your answer
Street Address
Your permanent home address.
Your answer
Your answer
Postal Code
Your answer
Telephone number
Your answer
Level of Education
You must be a returning student in order to participate in the Youth Corps. Please enter the level of education you are currently undertaking (to which you will be returning in the fall).
Name of educational institution
The name of the educational institution in which you are currently enrolled, or will be beginning in the fall.
Your answer
Field of study
Your answer
Do you self-identify as being part of a minority group?
If you would like to add any comments about your selection(s) above, please add them here.
Your answer
Do you have any of the following certifications?
Select all that apply.
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