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Neighborhood Advisory Board Membership Application

Click here to download the paper application and detailed instructions for the digital application.

The Department of Youth and Community Development (DYCD) is using this application to determine the eligibility of the applicant to serve on their Neighborhood Advisory Board (NAB). The application looks at the candidate’s satisfaction of membership requirements as set forth in the Rules and the By-Laws of the Community Services Block Grant/Community Action Program, such as whether an applicant: (1) has been a resident for at least six months of the Neighborhood Development Area (NDA) served by the NAB, (2) is over 16, and (3) has a record of community involvement, particularly with issues of poverty. Furthermore, this application looks at any potential or actual conflicts of interest which may arise from personal, business or professional affiliations. Neither the applicant nor anyone in his/her immediate family or household can be employed by DYCD or by an organization which receives NDA funding.

* Indicates required fields

Include an image of a recently postmarked official envelope addressed to you as proof of address. For example, a utility bill or other piece of business mail. For your privacy, please do NOT include account or social security numbers or billing amounts.
Can you accept calls at work?
Do you use Facebook, Twitter, Instagram or other social media?
Are you at least 16 years old?*
Are you or your spouse, parent/in-law, non-emancipated child or anyone else in your household an employee of the Department of Youth and Community Development (DYCD)? If yes, you are ineligible to serve as an NAB member.*
Are you, your spouse, parent/in-law, non-emancipated child or anyone else in your household, directly or indirectly currently involved with, or employed at, DYCD-funded contract agencies, or an agency which is seeking DYCD funding?*
Have you ever served previously on an NAB or an Area Policy Board?
In order to serve on the Board you must not have any conflicts of interest as described in the "Conflict of Interest Rules"
Have you read the Conflict of Interest Rules? *
Please check any civic, fraternal and community organizations in which you are, or have been active*
Please note: Although volunteers, NAB members are involved in implementing the Community Action Program in New York City and have impact on the distribution and allocation of program funds. As such, by becoming An NAB member you should be aware of and understand the seriousness of the responsibilities you are proposing to undertake. Further, as this application is for membership to an advisory board to a public agency, the Freedom of Information Law (FOIL) may, upon request, allow for public review of the information contained in this application.
Declaration and Certification*

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