My Brother's & Sister's Keeper Youth Council 2023-24 Membership Application

My Brother's & Sister's Keeper Youth Council 2023-24 Membership Application

My Brother's & Sister's Keeper Youth Council 2024-25 Membership Application

The New York City Department of Youth and Community Development (DYCD) in collaboration with the Young Men’s Initiative (YMI) and I WILL GRADUATE Program is looking to create a platform for young people throughout NYC that amplifies Youth-Voice and Youth-Choice. This council will be the galvanizing body that connects and mobilizes youth councils across the city. Are you ready to take action? Are you ready to be the next generation of social and civic influencers? If your answer is yes, your next step to action is for you to complete the form below for an opportunity to serve on this council. To qualify, you must be a NYC resident, have an interest in social change/action, must be between the ages 16-24 and passionate about the issues effecting youth across the City, in particular gun violence. Questions? Contact I WILL GRADUATE at Oroberts@iwgprogram.com, 718-385-3133 or DYCD at kbissette@dycd.nyc.gov or 646-343-6405.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Name of School*
Age (Participant Must be between 16 - 24 years of age)*

MonthDayYear
Date
Are you part of a DYCD-funded program or other community youth group ?*
Why are you interested in becoming an MBSKYC representative? **
Hint: What you love to do and the issues you care about?
Are you able to commit to a one-year commitment from July 1st 2023 to June 2024? This will require a minimum of 8 hours of monthly time commitment (excluding retreats or special events).*

YesNo
Are you able to travel to throughout the City (Brooklyn, Bronx, Queens, Manhattan, Staten Island)for meetings with their peers and provide HUB support?*

YesNo
Are you able to participate in weekly Council Meetings and attend “Super Saturday” training?*

YesNo
Are you able to work closely with other members to complete action plans developed by the council?*

YesNo
Are you able to participate in weekly Council Meetings and attend “Super Saturday” training?*

YesNo
If you have the opportunity to present your recommendations and ideas to local leaders, what would you want your local leaders/officials address? *
Hint: What are most passionate about? What community or social impact issue would you like to address?
If you have the opportunity to present your recommendations and ideas to local leaders, what would you want your local leaders/officials address? *
Hint: What are most passionate about? What community or social impact issue would you like to address?
Will your project address any of the following issues? (You can select multiple issues or add your own.)*

EnvironmentVoter RegistrationGun ViolenceBias and PrejudiceBullyingFood JusticeEducationEqualityHealthHuman RightsGang ViolenceAnimal RightsOther
Are available to participate in My Brothers Sisters Keeper Youth Council (1) Day - Overnight Leadership Retreat on October 13th - 15th, 2023?*

YesNoMaybe

Please list all the extra-curricular activities and or clubs that you were in or will be involved in 2023 year, the position you held/will hold the number of years you participated in that activity and the hours per week spent doing that activity. *

Rows	Activity Name	Position	Year Active	Hours Per Week	Day's of the Week
1
2
3
4

Please list two references: A reference is someone who knows you well and would write favorable of you. This person might be a teacher, mentor, job-supervisor, counselor, a peer-friend that shares your passion for advocacy, advisor and/or coach. Reference should not be a family member. *

Rows	Reference 1	Reference 2
Name
Email
Telephone
Relationship to you

Parent Name *

First NameLast Name
Parent Contact *
Please enter a valid phone number.Format: (000) 000-0000.
Parent Email*
example@example.com
Is there anything else we should know?
Should be Empty: