2019- 2020 New Youth Conservationists Application Form
Christodora's 2019- 2020 New Youth Conservationists (NYC) is open to
middle and high school students who are residents of New York City.
Student First Name
Student Last Name
Gender (Check One)
What is the program that helped you apply?(Partnering Program Name)
Student Cell Phone
District Of Columbia
Northern Mariana Islands
PRIMARY Guardian/Parent Info:
Primary Legal Parent/Guardian Name
Parent/Guardian Home Phone
Parent/Guardian Cell Phone
Parent/Guardian Work Phone
Language(s) Spoken by Parent/Guardian
You most identify with (check all that apply):
African American/Black (including Africa & Caribbean)
Hispanic/Latino (including Spain)
White (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
Summer Camp Session at Manice Education Center
Summer Ecology Program
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:
Please answer the following questions:
Why do you want to join the New Youth Conservationists? What would you like to accomplish by participating in this program?
Have you worked in a group before? What excites you about group activities?
To respect each groups progress and to get most out of this experience, we expect registered participants to commit to attending to each of the following 2019 Saturdays: 09/21- 12/14. Can you attend each of these Saturdays? If not, which Saturdays and why?
Note: There is a $20 registration fee to join NYC
Please review your application before submitting your form.
Need assistance with this form?