Youth Challenge Academy Application (Oahu)

LEGAL DECLARATION [Submit Abstract/Letter of Clearance]

ALCOHOL AND DRUG FREE DECLARATION [Submit Academy-Approved Drug Test]

By my initials, I understand that the Hawaii National Guard Youth Challenge Academy, (YCA) is and Alcohol, Tobacco and Drug free environment, with a Zero Tolerance policy against drug use. I understand that I will be subject to random drug and toxicology screenings at anytime while attending YCA and if I am found to test positive for substance abuse or am caught in posession of any of the aformentioned substances, I may be dismissed from YCA immediately without notice.

MEDICAL DECLARATION [Submit Medical Physical Clearance within 12 months]

By my initials, I understand that the YCA is physically, emotionally, and mentally demanding and that it is my responsibility to inform the YCA staff of any pre-existing medical issues or concerns prior to my being accepted into the YCA program. To ensure that I am physically prepared for the YCA, I am required to complete a standrad Hawaii DOE sports physical and provide a copy of that physical to the YCA addmissions staff. Also,upon my reporting to the YCA, I am required to turnover all prescribed medications and accompanying documentation to the YCA medical staff who will monitor my use of this medication in accordance with all physician's

I understand that I am required to find a mentor to assist me in completing the YCA program. This mentor must be at leaset 23 years old, the same gender as myself, cannot live in my household, cannot be a parent or grandparent and must pass a criminal background check. This mentor must commit to attending an 8-hour training session and be willing to visit with me at least once a week during the 3rd and 4th months of the YCA residential program. Upon my graduation, this mentor will be required to submit weekly reports on my progress towards achieving my life goals as etablished during the residential portion of the YCA program.

By my initials, I understand that I may be discharged if I do not provide a trained mentor by week 13.

I certify that the responses provided on this application form are complete and true to the best of my knowledge and belief. I understand that providing incomplete, incorrect, or false information may result in the rescission or denial of my admission. I agree to provide documents relevant to the determination of my ressidency status and age as required by national guidlines. Furthermore, I understand that the YCA shares a common database and personal information may be accessed by authorized Youth Challenge Academy and National Guard personnel.