OMB control number
Youth Conservation Corps Application and Medical History Forms
OMB 1093-0010 · DOI/OS.
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 2026-11-30 and is listed under ICR 202503-1093-001.
Latest Forms, Documents, and Supporting Material
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202503-1093-001 | No material or nonsubstantive change to a currently approved collection | 2025-03-27 | ||
| 202311-1093-001 | Revision of a currently approved collection | 2023-11-06 | Approved with change | |
| 202307-1093-001 | Extension without change of a currently approved collection | 2023-08-16 | Improperly submitted and continue | |
| 202101-1093-001 | No material or nonsubstantive change to a currently approved collection | 2021-01-29 | Approved without change | |
| 202001-1093-001 | New collection (Request for a new OMB Control Number) | 2020-08-21 | Approved with change |
OMB Details
DI-4014, Youth Conservation Corps Application
Federal Enterprise Architecture: Natural Resources - Conservation, Marine and Land Management
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form DI-4014 | YCC Member Application Form | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.