Screenshots Design Team Nomination Form
Media Power Youth and the STEM Discovery Lab at UNH Manchester are seeking talented youth leaders to help us build a new educational program. Together, we'll explore how our technology habits can affect mental health and relationships and design educational experiences to prepare young people for the challenges they will likely encounter in digital spaces. Students grade 9 through 12 are invited to apply through an online application. We are seeking to create a collaborative team of students with varying backgrounds, interests, and ways of problem-solving. By sharing their perspective on the challenges youth face online, participants will be helping to foster digital communities that are authentic and supportive for friends, family, and younger students.

We require that a teacher/counselor/administrator nominate a student for this program. To nominate a student for the Screenshots Design Team, please fill out the information below. We ask that you also provide your contact information so we can reach out to you with any follow-up questions.

All applications and nominating forms must be received no later than October 12th. All forms and program information can be found online at The application process and all meetings will be facilitated online due to COVID-19 guidelines. If you have any questions about the application or the program, please contact Heather Inyart at or Sarah Grosvenor at
Program Description
This opportunity is provided by Media Power Youth, a nonprofit organization that empowers youth to use media in creative and responsible ways that support well-being, in partnership with the STEM Discovery Lab at UNH Manchester. Participants will create a project-based learning module for middle school students driven by the underlying questions: What do teens need to do and know in order to build a strong, safe, and supportive online network?

High school students in grades 9 to 12 are invited to apply. The application can be completed online at The application deadline is October 12th. Selected students will meet via Zoom on Thursday afternoons from 3:30pm to 5:30pm from October 22nd to December 17th. Students must have reliable internet access to participate and consent to provide feedback on their experience through a focus group and/or survey questionnaire at the end of the program. Students will have the option of staying involved with Media Power Youth (if they choose) to help implement their ideas with middle school students in the Spring of 2021.

This opportunity meets a variety of ISTE and health educational standards and students may be able to earn extended learning opportunity (ELO) credits for their participation. Students seeking ELO credits are advised to note this on their application so that we can coordinate as needed with their local school district. Decisions on whether or not to grant ELO credits are made locally by school administrators.

Thank you for taking the time to share this opportunity and for nominating one of your students. If you have any questions about the application or the program, please contact Heather Inyart at or Sarah Grosvenor at
Student First Name *
Student Last Name *
Nominator First Name *
Nominator Last Name *
Nominator Email *
Phone *
School *
Role *
If you are a teacher, what subject do you teach?
What grade do you teach?
Relationship to Student *
Why do you nominate this student for this program? *
Please provide three adjectives that best describe the student: *
Never submit passwords through Google Forms.
This form was created inside of Media Power Youth. Report Abuse