2026 IYCE Summer Program Application

IYCE Summer Program Application
Applicant Information
Full Name

First NameMiddle NameLast Name
Age
Gender
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City / State / Zip
Phone Number (Applicant)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Applicant)
example@example.com
School Name
Current Grade
Parent / Guardian and Emergency Contact
Parent / Guardian Name

First NameMiddle NameLast Name
Relationship to Applicant
Phone Number (Parent / Guardian)
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (Parent / Guardian)
example@example.com
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Medical and Signatures
Medical Conditions or Allergies
Parent/Guardian Signature
Parent/Guardian Signature Date

MonthDayYear
Date
Applicant Signature
Applicant Signature Date

MonthDayYear
Date
Applicant Profile and Interest Questions
Tell us a little about yourself (age, grade, interests, hobbies)
What three words would you use to describe yourself?
What activities or topics do you enjoy the most right now?
What does a typical day look like for you during the summer?
Why are you interested in joining the IYCE Summer Program?
What are you hoping to learn or gain from this experience?
Have you ever participated in a program focused on personal growth, leadership, or mental health? If yes, what was it like?
Mental Health Questions
What topics interest you most?

Other
If Other, please specify
When you hear the term “mental health,” what does it mean to you?
On a scale of 1–10, how important do you think mental health is for teens?
Why did you choose that number for importance of mental health?
What are some challenges teens your age face when it comes to mental health?
Where do teens usually go for support when they are struggling?
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IYCE Summer Program Application

Applicant Information

Parent / Guardian and Emergency Contact

Medical and Signatures

Applicant Profile and Interest Questions

Mental Health Questions