Throggs Neck EMS Corps Youth Corps Application
We are currently accepting applications for those who are 13-17 in high school school for our Youth Corps Program set to begin in late February.  The Youth Corps will receive hands on training on emergency medical skills, will be involved in community services, and will learn leadership skills that will last a life time.  Our group meets at our base located at 3955 East Tremont Avenue, Bronx, NY 10465 for 2 hours twice a month.  These meetings may also be held via Zoom unless announced in advance.  All participants get community service awards and are eligible to enter EMS Youth Corps competitions.  Once your application is complete, we will contact you for an interview.  Good luck and thank you for applying to be part of our 2024 Youth Corps Cohort.
Sign in to Google to save your progress. Learn more
Email *
Name *
Address *
Email Address *
Cell Phone Number.
Date of Birth *
Parent/Guardian's Name: *
Parent/Guardian's Contact Phone Number: *
Parent/Guardian's Email Address *
Name of School *
Please choose current grade *
How would you rate your grades in school? *
I need support and am failing some classes.
I am on the honor roll and have high grades.
What are your school hours? *
Which best describes your current school situation? *
I would like my child to participate in Youth Corps Training and activities: *
Do you have your immunizations and a physical up-to-date that you are able to provide? (If not, will you be able to get this before starting the Youth Corps?) *
Please list any extracurricular activities you are currently part of.  If none, please write "none". *
Do you have an IEP or require any accommodations?   We will have exams and events and want to make sure we support everyone.
Clear selection
What is your experience with community service? *
Does any of the following apply to you? (Check all that apply.) *
How would you rate your interest in a future career in the medical field? (We accept youth with all interests.  These questions are for informational purposes.) *
I am not considering a career in the medical field at all.
I have decided to become a doctor/nurse/EMT or other medical professional.
Attendance is very important.  Would you be able to commit to attending our meetings once the dates are announced? *
Our Youth Corps will be required to wear a basic uniform that will be announced if you are accepted.  Would you agree to coming to our meetings in full uniform every time?  This includes wearing your polo during Zoom meetings.  *
Youth Corps members will have the opportunity to attend EMT School upon graduation of high school if they are a member in good standing.  Would you be interested in getting your EMT certification? *
Do you have a parent or guardian that is interested in volunteering with TNVAC? *
We are unable to provide transportation to and from our base.  Would you be able to find safe, reliable transportation? *
Our Youth Corps may be asked to engage in community events.    We will announce all of the events and are aware that schedules change.  Please indicate what days you will be able to participate. *
Do you have any other obligations or responsibilities we should be aware of?  If none, please type "none". *
What is reason you are applying to our Youth Corps?  (Check all that apply) *
How did you hear about our program? *
Do you know any of our members or board of directors?  Please put there name(s) below.
If you have answered every question above to the best of your ability and would like to be considered for a place in our youth corps, please type /s/ and your name below. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy