NYC Digital Media Center Spring & Summer Program
Thank you for your interest in the first ever, radio, television and production studio program with the NYC Digital Media Center. Please fill out the form below By March 1, 2023 5 PM EST.
BASIC INFORMATION
Student's Full / Legal Name
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First Name
Last Name
Student ID:
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Student Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Student Phone Number
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Area Code
Phone Number
Student E-mail
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Student Birth Date
January
February
March
April
May
June
July
August
September
October
November
December
Month
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Day
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
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1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
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Academics
Academic GPA(Average)
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PERSONAL DATA:
(optional scholarship identification for specific scholarships)
Ethnic Background (Check all that apply)
African/American
Asian/Pacific Islander
Portuguese
Filipino
Slavic
Swiss
American Indian
Italian
Chinese
Puerto Rican
Hispanic
Vietnamese
Japanese
Other
Disability
Please Select
Physical
Learning
Hard of Hearing
Blind
Other
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SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:
List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
School Activities / Offices Held 1: (not sports)
School Activities / Offices Held 2: (not sports)
School Activities / Offices Held 3: (not sports)
School Activities / Offices Held 3: (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Sports Participation 3
Will you be participating in a sport(s) this year?
Yes
No
What Sport?
Travel Experience or Unusual Experiences (study abroad, etc.)
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
School / Community Awards and Honors 2
School / Community Awards and Honors 3
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Guardian/Parent Details
Father/Stepfather/Guardian Name
Father/Stepfather Employer and Occupation
Mother/Stepmother/Guardian Name
Mother/Stepmother Employer and Occupation:
Number of dependents in home:
First generation to attend college?
Yes
No
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STUDENT STATEMENT: Please describe in 4 sentences why you are interested in this program along with submitting a :30 second video.
*
Thank you for applying to the NYC Digital Media Center.
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