Youth Conservation Corps Application and Medical History Forms

OMB 1093-0010

OMB 1093-0010

Under the Youth Conservation Corps Act of August 13, 1970, as amended (U.S. 1701–1706), the U.S. Department of Interior and the U.S. Department of Agriculture-U.S. Forest Service provide seasonal employment for eligible youth 15 through 18 years old. The Youth Conservation Corps stresses three important objectives: 1. Accomplish needed conservation work on public lands; 2. Provide gainful employment for 15 to 18 year-old males and females from all social, economic, ethnic, and racial backgrounds; and 3. Foster, on the part of the 15 through 18 year-old youth, an understanding and appreciation of the Nation’s natural resources and heritage. Youths seeking training and employment with the Youth Conservation Corps must complete the following new common forms included in this emergency clearance request: DI-4014, “Youth Conservation Corps Application” and DI-4015, “Youth Conservation Corps Medical History.” The applicants’ parents or guardians must sign both forms. The application and medical history forms are evaluated by participating agencies to determine the eligibility of each youth for employment with the Youth Conservation Corps. Potential and actual agencies that may use the common forms included in this collection include: • U.S. Fish and Wildlife Service (Interior); • National Park Service (Interior); and, • Other Federal Departments and Agencies such as the U.S. Forest Service (U.S. Department of Agriculture).

The latest form for Youth Conservation Corps Application and Medical History Forms expires 2023-10-31 and can be found here.

OMB Details

DI-4014, Youth Conservation Corps Application

Federal Enterprise Architecture: Natural Resources - Conservation, Marine and Land Management

Form DI-4014United States Youth Conservation Corps - Crew Member ApplicationFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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