Youth Advocacy Corps Application - 2018 Youth Advocacy Summer Institute
THANK YOU for your interest in applying to be part of the Youth Advocacy Summer Institute in Brooklyn, New York.

★Please Note that the program runs from July 10 through August 17, 2018. We will meet five days per week (M-F) from 9:30-3:30 each day. Applicants should be between 16 and 22. ★

INSTRUCTIONS: Complete this application for Youth Advocacy Corps and submit it ASAP. Please be sure to answer every question and do not leave any blank. If you have questions, please email: info@advocacycorps.org.



Email address *
PART 1: PERSONAL INFORMATION
Name *
Your answer
Full Address *
Please tell us where you live (Street, City, State, Zip Code)
Your answer
What neighborhood do you live in? *
(i.e., Sunnyside, Crown Heights, Harlem).
Your answer
Phone Number *
Your answer
Email Address *
Your answer
What is the best way to reach you? *
Required
What is your date of birth? *
MM
/
DD
/
YYYY
THE FOLLOWING THREE QUESTIONS ARE REQUIRED IF YOU ARE UNDER 18:
Name of Adult Contact Person: *
Your answer
What is your relationship to Adult Contact Person: *
(i.e., father, mother, legal guardian, foster parent, aunt, uncle)
Your answer
Phone number and/or email address of Adult Contact Person: *
Your answer
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