Admission Documents – Hilo Job Challenge Academy
HILO CAMPUS ONLY
Serving Graduates from Youth Challenge Academy
- Application (Completed/Signed by Graduate and all custodial parents/guardians are sent back to JCA)
- Birth Certificate – copy
- Medical Insurance Card – copy
- Social Security Card – copy
- Government issued ID – copy (School IDs are not accepted)
- Associate & Parent Contract(Completed/Signed by Graduate and all custodial parents/guardians are sent back to YCA)
- Emergency Contact Information (Completed/Signed by all custodial parents/guardians are sent back to JCA)
- Drug & Substance Abuse Policy Acknowledgement (Completed/Signed by all custodial parents/guardians are sent back to JCA)
- Medical Aid Station & Consent to Administer (Completed/Signed all custodial parents/guardians are sent back to YCA)
- Medical Forms & Responsible Party Payment Information (Please fill and sign everything. Medical Treatment Authorization, HMC Communication Form, and Dental and Payment Information (Insurance)).
- Juvenile Criminal Report (This is REQUIRED for all applicants regardless of personal history. Requests are processed at your Family Court, results are sent back to JCA)
Full Application – please print double sided if possible
Completed documents can be sent to:
Email: [email protected]
Mail: PO Box 5210 Hilo, Hawaii 96720
Phone: 808-430-4184
Contact: Sayan Polota (JCA Admissions Coordinator)
Email: [email protected]