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NYC Administration for Children's Services: The City's child welfare agency, dedicated to protecting children and strengthening families

HIGH SCHOOL GOAL WEEKEND - Youth Application

NYC Children’s Services and the NYC Department of Education are hosting HIGH SCHOOL GOAL WEEKEND. This event is an opportunity for 7th and 8th graders currently in foster care to get VIP access to the Citywide High School Fair, learn about the High School Admissions process, and receive 1-on-1 attention and assistance with completing the required application due on December 3, 2012!

All participating youth will receive a FREE MetroCard, breakfast & lunch, and other great prizes!!!

Please complete this application for EACH young person

Applications must be received by the deadline of SEPTEMBER 14, 2012!
DON’T DELAY - REGISTER TODAY!

DO NOT USE THIS FORM TO REPORT CHILD ABUSE!

Name of Youth
Age
Date of Birth (Month - Day - Year)
Current Address City, State, Zip code
Phone Number
Which day will the youth attend? Please choose ONE	Saturday, September 29, 2012
	Sunday, September 30, 2012
Name and Location of Middle-School the youth is currently attending
Is the youth in 7th or 8th grade?	Yes No
DOE OSIS Number
Do the foster parents/guardians of the youth applicant need language interpretation services?	Yes No
If YES, what language?
Name of Foster Care Agency responsible for the youth
Name of Case Worker
Phone Number
Email Address
Who will chaperone/accompany the youth to the event?
Chaperone Phone Number
Chaperone Email Address

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