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NYC Administration for Children's Services: The City's child welfare agency, dedicated to protecting children and strengthening families
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HIGH SCHOOL GOAL WEEKEND - Youth Application

  
NYC Administration for Children’s Services is hosting a special HIGH SCHOOL GOAL WEEKEND event on November 15, 2014 from 9am -1pm at ACS, 150 Williams Street, New York, NY 10038. This event is an opportunity for 8th and 9th graders currently in foster care or recently adopted, who may have missed the annual HSGW held earlier this year, to learn about the High School Admissions process, and receive 1-on-1 attention and assistance with completing the required application due on December 2, 2014!

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

All participating foster parents will receive annual training credits!!

Please complete this application for EACH young person

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 

 

Name and Location of Middle-School
the youth is currently attending

 

Please choose the grade the youth is in.   

 

DOE Student ID/OSIS Number (if known)

 

Do the foster parents/guardians of
the youth applicant need language
interpretation services?
 
 

 

If YES, what language? 

 

Name of Foster Care Agency
responsible for the youth

(if no agency, please write in “Adopted”
and skip to chaperone information)

 

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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