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 Serve your Community. www.nationalservice.gov

There are two methods for submitting your Registration Application:

  • You may complete the Registration Application online.
  • You may print off the Registration Application pdf, complete the application manually, and send the application to:

    Platinum Torch National Office
    297 Route 72 West Suite #113
    Manahawkin, NJ 08050-2890

    NOTE: If you are under 18 years of age, this is the method you must use because a parent/guardian must sign the application.

If you are joining for the first time and wish to use community service that you performed within the past 6 months toward your achievement level, there are three sections for the Service Organizations, depending on how many you may need. These are not required fields, so only use them towards your achievement level.


* Required Fields

Personal Information
 * First Name Middle Initial * Last Name
* Birth Date (mm/dd/yyyy) * Graduating Year (yyyy) * Sex
Male Female
Permanent Mailing Address
 * Street Address 1 Street Address 2
* City * State * Zip Code
* Phone (aaa)xxx-nnnn * E-Mail
School
 * School Name * City * State
Service Org 1
 * Organization Name * Contact Name
(If needed)
* Street Address 1 Street Address 2
* City * State * Zip Code
* Phone (aaa)xxx-nnnn E-Mail
* Start Date (mm/dd/yyyy) End Date (mm/dd/yyyy) * Number of hours
Service Org 2
 * Organization Name * Contact Name
(If needed)
* Street Address 1 Street Address 2
* City * State * Zip Code
* Phone (aaa)xxx-nnnn E-Mail
* Start Date (mm/dd/yyyy) End Date (mm/dd/yyyy) * Number of hours
Service Org 3
 * Organization Name * Contact Name
(If needed)
* Street Address 1 Street Address 2
* City * State * Zip Code
* Phone (aaa)xxx-nnnn E-Mail
* Start Date (mm/dd/yyyy) End Date (mm/dd/yyyy) * Number of hours
The most important thing I learned from community service is ...
I certify that to the best of my knowledge I have answered the application truthfully.
I understand that if I have misrepresented any information in the application the
Platinum Torch National Service Honorary may consider me ineligible for membership.
* Required Fields