YMCA Youth Trust Student Nomination Form
Nominations should be 8th grade students for the 2024 - 2025 School Year
Name of student being nominated:
*
First Name
Last Name
Student's age:
*
Student's gender:
*
Please Select
Male
Female
Non-binary
Gender neutral
Other
Prefer not to answer
Student's contact phone number:
*
Please enter a valid phone number.
Student's contact email address:
*
example@example.com
Student's contact mailing address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Caregiver's Name:
*
First Name
Last Name
Parent/Caregiver's phone number:
*
Please enter a valid phone number.
Parent/Caregiver's email address:
*
example@example.com
What is YOUR name?
*
First Name
Last Name
What school or other organization are you representing?
*
What is YOUR email address?
*
example@example.com
What is YOUR best contact phone number?
*
Please enter a valid phone number.
Submit
Should be Empty: