YP Form - Infant Crisis Services

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Young Professionals Board Application

First Name *

Last Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City *

State *

ZIP Code *

Age Range *

Gender *

Place of Employment *

Job Title *

Job Responsibilities *

Years of Residency in Oklahoma *

Have you previously applied to be part of the Young Professionals Board? *YesNo

How did you hear about the Young Professionals Board? *

Why are you applying for the Young Professionals Board? *

Please list in order of importance all activities you are currently involved in. *

What else would you like us to know about you? *

Board Member Responsibilities

Please review the attached board committees and requirements:
2026 Young Professionals Board Committees & Requirements (PDF)

I understand these responsibilities and will do my best to participate fully.

Please upload your resume. *

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Infant Crisis Services

Donald W. Reynolds Center
4224 N. Lincoln Blvd
Oklahoma City, OK 73105

405-528-3663

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Donor Hours

Monday – Friday
9:00am – 4:00pm

Service Hours

Monday – Friday
9:00am – 3:30pm