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6th Grade Nomination Form (2021-2022)


Breakthrough New York (BTNY) is seeking exceptional 6th grade students to apply to our 10-year college success program!

School administrators, guardians, and even prospective BTNY students themselves are invited to nominate current 6th grade students to apply to BTNY!

The nomination process is critical to our admissions outreach, as it helps us get directly in touch with a wide group of NYC students who may be eligible for our program.

WHO can be nominated for BTNY?

Students who meet our eligibility criteria, including:
  • Current NYC 6th graders attending a public, charter, or parochial school 
  • Students who are earn an 83% or above in their core 6th grade classes (ELA, Math, Science, and Social Studies) by the time of their first 6th grade report card 
  • Students who come from a low-income background (see our website to learn more about how we assess this!)
IF you are a school submitting nominations for BTNY, please know that you will be asked to submit the following information for each of your nominees. Having as much contact information as possible helps us make sure we can get in touch with students about applying. The minimum we request is the Student Name, and at least 1 phone number and email address where we can reach the family.
  • Student Name
  • Student E-Mail
  • Guardian 1 E-Mail
  • Guardian 1 Cell Phone
  • Guardian 2 E-Mail 
  • Guardian 2 Cell Phone

What is the benefit of submitting a BTNY Nomination?

While you don't need to be nominated in order to apply to BTNY, submitting a nomination for BTNY will help you access the following benefits:
  • Students: early access to our online application, and reminders about upcoming application deadlines
  • Guardians: reminders about upcoming Information Sessions, reminders about student application status and upcoming deadlines
  • School administrators: application status updates on your BTNY applicants, as well as reminders about Information Sessions and upcoming deadlines
Nominations will be open from though January 7th, 2022.


If you need any support in using this form, 
please contact Enya O'Riordan, Admissions Director, 
at enya@btny.org or call 917-258-6564. 



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Nominator Information

School Nominator Information







Student Nomination (for Guardians)











Student Self-Nomination
















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BTNY Nomination Instructions
School administrators are invited to submit nominations from their school in one of two ways:

  • OPTION 1 (Preferred!): Enter as much of the following information as possible (so we are more likely to reach the student/family): Student Name, Student Email, Guardian 1 E-Mail, Guardian 1 Cell PhoneGuardian 2 E-Mail, Guardian 2 Cell Phone.
  • OPTION 2: Attach a spreadsheet of the same information listed above.
Option 1 (Preferred)
Please use the form below to nominate individual students for BTNY by sharing their contact information. If you would like to nominate more than one student please click the "Add another response" link as many times as you need.

If you are missing guardian contact information for any of your students, please input the student's school e-mail or your own contact information instead.







Option 2
Please upload your nomination information below:

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Next Steps
By clicking the "Submit" button below. you will be submitting nominations for BTNY. Following submission, our team will begin conducting direct email and phone outreach to your nominees, to encourage them to learn more and apply. Our team will also provide nominators with updates on the admissions status of their nominees.
Summer 2022 Instructional Coach Role!
Every summer, BTNY hires full-time teachers to act as Instructional Coaches in our summer program for middle school students. Instructional Coaches oversee a department of 3 undergraduate Teaching Fellows in one of four academic disciplines (Literature, Math, Science, and Social Studies.)

This role was designed to support classroom teachers who are interested in developing their skills as instructional leaders. Past Instructional Coaches have gone on to become Academic Deans and Instructional Coaches in full-time school settings.

All nominators are encouraged to apply online (or share with your networks) by January 30th, 2022.


Visit www.btny.org for more information, or call (646) 747-2869