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Lead UC Youth Application

Please complete each section in full.
Applications may also be typed or handwritten and submitted to:
Lead UC Youth Program/UCDA
301 W. Montgomery Street
Creston, IA 50801


  1. The student must complete and submit SECTION I-STUDENT INFORMATION.
  2. The adult/peer reference must complete and submit SECTION II-REFERENCE INFORMATION. The adult/peer reference should be an individual that is personally acquainted with the student, and will continue to have contact with the student throughout the next school year. The reference should not be a family member of the student. This form can be used to nominate a student for the program.

An application tutorial can be found here.

If you have any questions regarding the Application or Reference Form, please contact:

Mindy Stalker, UCDA Talent Development Director –  641-782-2003

Due Date: The Application period is now closed for 2019.