IYI Prospective Student Contact Form

YouthBuild




Address Information





Contact Information



Required Documentation
Note: When you are scheduled for an application appointment you will need all of the following documents:

·         Proof Of Age
  • o    Driver's License,

    o    Birth Certificate,

    o    Alien Registration Card,

    o    Baptismal Certificate (must show birthplace),

    o    Hospital Record of Birth, Passport,

    o    Honorable DD-214 (must show birthplace),

    o    Public Assistance/Social Service's Record

     

    ·         Proof of Total Household Income

    o    Unemployment  Printout  (from  UI  Representative)  printout  of  cash  public  assistance  (copy  of authorization to receive cash public assistance), copy of public assistance identification card

    o    Non-Public assistance source (proof of last 6-months income, most recent pay stubs with year to date, social security benefits letter listing monthly amount received for each family member, or copy of latest check, latest unemployment stub, Supplemental Security Income (SSI), pension benefits, child support payments (check stub), latest Medicaid ID card

    o    Food Stamps: receipt, card with current date, letter from food stamp office, public assistance record/printout.

    ·      Proof of Citizenship/Allen Status

    o    Alien Registration card indicating Right to Work

    o    Baptismal Record (only if place of birth is shown)

    o    Birth Certificate

    o    Hospital Record of Birth

    o    Food Stamp Record

    o    Public Assistance Records

    o    U.S. Passport

    o    Naturalization Certificate

     

    ·         Proof of Selective Service Registration (for male 18 and over, born after 1960)

                                    

    ·         Social Security  Number

    o    Social Security Card

    o     Letter form Social Services Agency

    o    Pay Stub

    o    Social Security Benefits

    o    W-2 Form

     

    ·         Proof of Barrier

    o    Deficient in  Basic Literacy Skills: assessed by a Standardized Test or TABE.

    o    School Dropout: (Letter from departure school) Applicant Statement: Information from individual's school regarding enrollment status

    o    Homeless, Runaway or Foster Child: Applicant Statement: Written Statement from an individual providing temporary residence; written Statement from shelter; written statement from social service agency

    o    Pregnant or Parenting; Applicant Statement; Birth Certificate; hospital record of birth; Physician's note; referrals from official agencies; school program for pregnant teens; school records; written statement from social service agency

    o    Offender; Applicant Statement; Court documents; Halfway housed resident letter of parole; letter from probation officer; police records


Captcha

Please enter the characters you see in this picture:

Visual CAPTCHA

This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen.
Can't see the image? Click here for an audible version in English.