Youth Leadership Council Application

Complete this online application or send it to NYCHA Resident Engagement, 250 Broadway, 11th Floor, New York, NY 10007

* - Required Fields.

Youth Leadership Council Requirements:

Full Name: *

Age: *

Development: *

Address: *

Borough/City: *

Zip Code: *

E-mail Address: *

Phone Number: *

Parent/Guardian's Full Name: *

Relationship to You: *

Parent/Guardian Phone: *

Parent/Guardian E-mail: *

High School Attending: *

Current Grade Level: *

Why would you like to serve on the Youth Leadership Council? *

Please list any relevant skills/strengths (e.g., community organizing, first aid, peer counciling, journalism, etc.): *

Please provide the names and contact information for two people to act as references.

Full Name: *

E-mail Address: *

Phone Number: *

Full Name: *

E-mail Address: *

Phone Number: *

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.