How did you hear about NJ Youth Corps of Sussex County?
How did you hear about us?
I received a letter.about the program.
I saw a flyer at school.
I saw a flyer at a store/restaurant.
My guidance counselor told me about it.
I read about it in the newspaper.
I saw an ad on Facebook.
I saw an ad on Instagram.
A friend or family member told me about it,
I work for a school or service agency.
I am filling out this form because I am...
looking for services for myself
looking for services for someone else
If you are looking for services for someone else, what is your relationship to that person?
other relative (aunt, uncle, cousin, etc.)
If you were referred by New Jersey Youth Corps alumni, please list their name.
Tell us about the potential Youth Corps member.
Resident of Sussex or Northern Warren County, NJ?
Between the ages of 16 to 25?
Do you need to obtain a G.E.D. or High School Equivalency Diploma?
Contact Information - Please share your information so we may contact you about NJYC!
Please select one of the following options.
I am looking for help. Please contact me directly.
Please contact me on behalf of someone I want to refer.
Agency or School Name
Armed Forces Americas
Armed Forces Other
Armed Forces Pacific
Newfoundland & Labrador
Prince Edward Island
The best time to reach me is
Business Hours 9AM to 5 PM
Morning 9AM to 11 AM
Lunch Hour 12 PM to 1 PM
Afternoon 1 PM to 4 PM
Evening 5 PM to 9 PM
My preferred contact method is:
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: New Jersey Youth Corps of Sussex County •• 127 Mill Street, Newton, NJ 07860 •• 973-940-3510 ••
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