UCCIE Corpsmember Application
Thank you for your interest in joining our the Urban Conservation Corps of the Inland Empire.  We are currently recruiting members ages 18-25 years.  After filling out this short application,  you will be contacted by our recruiter to attend and information session and learn the next steps to joining the team.

Thank you for your interest in UCCIE.  

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What location are you applying to?
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First Name (Full Legal Name) *
Last Name (Full Legal Name) *
Current Street Address *
Current mailing address if different than above
City *
Zip Code *
Phone Number *
Email *
Date of Birth *
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Are you a United States citizen? *
Do you have a high school diploma? *
If no, what is the highest grade you attended?
Do you have a GED? *
Do you have a college degree? *
Do you have transportation? *
Have you been court involved? If yes, check all that apply:
Have you been in the foster system? If yes, please check all that apply below:
Corpsmembers requires extensive and repetitive physical activities (heavy lifting, bending, standing for a long period of time, hiking on uneven terrain). Are you able to perform the essential function of this type of work for which you are applying for? *
List 3 work or school references that we can contact
Please do not list family members
#1 Reference Name & Number
#2 Reference Name & Number
#3 Reference Name & Number
How did you hear about this program? (Mark all that apply) *
Required
Other comments or information you would like us to know about you? *
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