NCYC Cultural Diversity Youth Forum Nomination Form
Please use this form to nominate a teenager from your delegation to participate in the Cultural Diversity Youth Forum. Please make sure your review the criteria for youth participants before completing this form.

NOTE: If you have already received a scholarship for youth participants to attend the Forum through the USCCB, you do NOT need to complete this form. The information requested here would have been collected as part of your process to request scholarship for the event.

We are looking for your help in identifying a youth participant from one of the six cultural families (that are identified by the USCCB) who will be represented at this Forum:
- African-American
- Asian Pacific Islander
- European American
- Hispanic / Latino
- Native American
- Migrants, Refugees, and People on the Move

Each diocese/delegation is welcome to nominate one (1) young person from each cultural family, but no more than three (3) youth in total (across all cultural families). They should already be part of your diocesan delegation. The nominees should also be able to participate in a video conference call prior to NCYC to help them prepare for their participation in the Forum.

Other requirements include:
- An awareness of their own cultural identity, which may include identification with more than one cultural and ethnic family
- A willingness to share from their own experiences
- The ability to participate and share in English*

If you have questions, please contact Darius Villalobos, NFCYM Director of Multicultural Ministry, if you have any questions: 202-753-8920 or
Name of diocese / delegation *
Your answer
Name of Delegation Leader (person making nomination) *
Your answer
Full name of nominee *
Your answer
Age of the teenager at time of NCYC (November 2019)
Your answer
Year in school of teen during NCYC 2019
Cultural community they represent *
Why would you recommend this youth for participation in the Cultural Diversity Youth Forum? *
Your answer
Will the teen need translation assistance? *
If so, what language do they need translation to? (English to ______)
Your answer
Will the teen have a chaperone that can accompany them to the Forum, if needed? *
Best email to contact adult who can share info with nominee *
Your answer
Adult contact's name
Your answer
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