Youth Council Registration

IACS Youth Council (YC)

Parent Email*

This parent contact will receive all confirmations.
Applicant Name*
First Last
Age*
Birthdate*
MM slash DD slash YYYY
Gender*
YC Applicant Pronouns*
School*
Grade- Sept 2022*
Applicant Email*

Parents, please do not provide your email for this field. We do need the applicant's email
Applicant's cell #*
Parents, please do not provide your phone number. If the applicant does not have a phone, just put 111-111-1111
Home phone*
Home address*
Street Address City ZIP Code
Are you a current YC ?*
- Yes
- No
If YC, how many years have you been a YC*
Mother's name*
Mother's email*
Mother's cell*
Father's name*
Father's email*
Father's cell*