New Mexico Youth Challenge Academy Application
Thank you for your interest in NMNGYCA.  Please complete all questions below.  
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Applicant Information
Please enter information about the Applicant.
First Name *
Last Name *
Applicant Date of Birth *
MM/DD/YYYY
MM
/
DD
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YYYY
Age *
Applicants must be between the ages of 15 to 18 [All applicants who are 15 upon enrollment must turn 16 on or before graduation date -  December 14th, 2024.]

*NOTE* Any applicants who are 15 upon enrollment on 07/14/24 will enroll in credit recovery courses, which will allow for their eventual return to high school upon completion of the NMNGYCA Program.  All 15-year-old applicants must submit HS transcripts.
County *
Applicant Phone Number *
(555)555-5555
Applicant Email Address *
APPLICANT@domain.com      -      Please enter an accurate email address - this will be used to communicate during the application process, as well during the residential phase
Mailing Address *
City *
State *
Cadets are required to get a government-issued ID from their home state of record.  
Zip Code *
Gender *
Race/Ethnicity *
What language do you speak most often? *
If you speak more than one language, please list in the next question.
Do you speak any languages other than the one listed above? *
Please list all languages spoken.
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