2019 Summer Ecology Program: Camper Application Form
Christodora's 2019 Summer Ecology Program is open to high school students who are residents of New York City and who will be 16 years old or older by July 2019.
New Camper Info:
Camper First Name
Camper Last Name
Gender (Check One)
Partnering Program Name
Camper Cell Phone
District Of Columbia
Northern Mariana Islands
You most identify with (check all that apply):
African American/Black (including Africa & Caribbean)
Hispanic/Latino (including Spain)
hite (including Middle Eastern)
Asian (including Indian subcontinent & Philippines)
Native American (including all Original Peoples of the Americas, HI,
How did you hear about Christodora?
(Please check all that apply)
Winter Ecology Program (educators were directly in your classroom during the school year)
3-Day Field Trip to the Manice Education Center with your school
New Youth Conservationists Weekend Program at the New York Botanical Garden
Recruitment event or camp fair
Online/social media search
Friend, family member, or educator told you about it. If so, please list their full name(s) below:
PRIMARY Guardian/Parent Info. Guardian/Parent must provide e-mail, phone number, or both:
Primary Legal Parent/Guardian Name
Parent/Guardian Home Phone
Parent/Guardian Cell Phone
Parent/Guardian Work Phone
Language Spoken by Parent/Guardian
Please answer the following questions:
Please describe why you would like to participate in the Summer Ecology Program (SEP).
What would you like to learn during your participation in our program? Why?
What interests you the most about science?
Have you ever been away from home before? If so, how long?
Please review your application before submitting your form.
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