Applicant Interest Form Thank you for your interest in applying to the New Jersey Youth ChalleNGe Academy. Please complete the online Applicant Interest Form below.Alternately, you can download the Applicant Interest Form and submit it via mail using the instructions provided. Applicant Interest Form August 2025 Updates Part I - Applicant Information1. APPLICANT LAST NAME2. APPLICANT FIRST NAME3. APPLICANT MIDDLE NAME4. APPLICANT DATE OF BIRTH5. APPLICANT GENDER Male Female Other6. APPLICANT CITIZENSHIP STATUS U.S. Citizen Legal Permanent Resident Other Part II - Parent / Guardian Information1. RELATION TO APPLICANT Parent Guardian Other2. LAST NAME3. FIRST NAME4. EMAIL ADDRESS5. CONTACT PHONE NUMBER6. ADDRESS6a. STREET (INCLUDING APT. #) 6b. CITY6c. STATE6d. ZIP Part III - School Information1. NAME OF CURRENT/LAST ATTENDED SCHOOL 2. CITY OF SCHOOL3. STATE OF SCHOOL Part IV - Applicant Background Information1. DOES THE APPLICANT HAVE A CURRENT IEP OR 504 PLAN? Yes No2. HAS THE APPLICANT GRADUATED HIGH SCHOOL / ALREADY HAVE A HIGH SCHOOL DIPLOMA? Yes No3. HAS THE APPLICANT EVER BEEN ARRESTED? Yes No3a. IF YES, LIST DATES AND CHARGES.4. HAS THE APPLICANT EVER BEEN ON PROBATION / DEFERRED DISPOSITION? Yes No4a. IF YES, LIST START & END DATES AND CHARGES.5. DOES THE APPLICANT HAVE ANY PENDING COURT DATES? Yes No5a. IF YES, LIST DATES AND CHARGES.6. HAS THE APPLICANT ATTENDED ANY RESIDENTIAL OR TREATMENT PROGRAM? Yes No6a. IF YES, WHAT WAS THE NAME, TYPE OF PROGRAM, AND DATES OF ATTENDANCE?7. HAS THE APPLICANT ATTENDED ANY YOUTH CHALLENGE PROGRAM BEFORE? Yes No7a. IF YES, WHICH ACADEMY?8. IS THE APPLICANT WILLING TO BE DRUG TESTED? Yes No9. HOW DID YOU HEAR ABOUT THE NJ YOUTH CHALLENGE ACADEMY? Internet Family / Friend School (Teacher / Counselor) Social Media Police / Government Agency Other (Not Listed)10. WHY DOES THE APPLICANT WANT TO ATTEND THE NJ YOUTH CHALLENGE ACADEMY? Part V - Statement of Understanding I fully understand that the New Jersey Youth ChalleNGe Academy is a residential Academy that includes GED instruction, military training and employment preparation. At this time, I am in good health and capable of meeting the rigorous physical training schedule I will experience at the New Jersey Youth ChalleNGe Academy. I am drug free and I do not have an active alcohol and/or drug abuse problem. The applicant/legal guardian understands that by submitting this pre-application, the applicant has NOT BEEN ACCEPTED. The applicant SHOULD NOT withdraw from, nor cease to attend, High School even if they have received a conditional acceptance letter until just before the ChalleNGe class start date. To the best of my knowledge, all statements made in this application are accurate and truthful. I further understand that the information I have given in the first four parts of this application is subject to verification and that I may be disqualified from the Academy if it is determined that the information I have provided is untrue. By submitting this pre-application, I agree that any information I provide may be stored and made available to any person having a legitimate need for the information. I further understand that New Jersey Youth ChalleNGe Academy personnel shall determine who has such a need for this information. By submitting this online form, I acknowledge the Privacy Notice for the New Jersey Department of Military Affairs. This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Part VI - SignaturesParent / Guardian signature is required regardless of the age of applicant. APPLICANT DATEPARENT / GUARDIAN DATE I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the Statement of Understanding above. We will send a confirmation receipt to the email address for the parent/guardian. SUBMIT Signup For Our Newsletter SUBSCRIBE Want to know more about us? Contact Our Team