GYEC Enrichment Program | Building Strong Identity & Responsible Citizenship

Global Youth Empowerment Center Academy

Online Enrollment Form

Complete this form to enroll your student in GYEC Academy programs. Our team will review your application and contact you with the next steps. All fields marked with * are required.

1

Student Information

Student First Name *

Student Last Name *

Date of Birth *

Grade Level *

School Name *

2

Parent / Guardian Information

Parent/Guardian Full Name *

Relationship to Student *

Phone Number *

Email Address *

Emergency Contact Name *

Emergency Contact Phone *

3

Program Selection

Select the programs your student is interested in:

After-School Academic Enrichment

Homework support, STEM learning, and mentorship

Saturday Youth Leadership School

Leadership skills, public speaking, and civic responsibility

GYEC Summer Program

Academic enrichment and career exploration

Youth Internship Program

Real-world career experience with businesses

Career & College Labs

Explore career pathways and college preparation

Junior Ambassador Initiative

Leadership and role model program

Youth Future Readiness Summit

Annual leadership summit and career conference

4

Student Interests & Goals

Areas of Interest

Career Interests

Leadership Goals

Special Talents or Skills

5

Academic & Support Information

Does the student need academic support? If yes, which subjects?

Allergies or Medical Conditions

Accommodations Needed

6

Permissions & Agreements

I authorize GYEC Academy to communicate with me regarding program updates and enrollment status. * I give permission for my child to participate in selected programs and activities. * I consent to emergency medical treatment if necessary. * I consent to use of student photos/videos for GYEC Academy promotional purposes. I confirm that the information provided is accurate and complete. *

By submitting this form, you agree to our privacy policy and terms of service.

What Happens After You Apply?

1

Application Review

Our enrollment team reviews your application and student information within 2 business days.

2

Contact & Consultation

We'll contact you to discuss your student's interests, goals, and recommended programs.

3

Enrollment Confirmation

Once confirmed, you'll receive enrollment details, payment information, and program start dates.

4

Program Begins

Your student starts their leadership journey with GYEC Academy and begins making an impact!

Questions About Enrollment?

We're here to help! Contact us anytime with questions about our programs or the enrollment process.

Email: info@gyecacademy.org

Phone: (123) 456-7890

Hours: Monday-Friday, 9am-5pm EST

Contact Us

Enroll Your Student