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
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First Name
Last Name
Email
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Name of School
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Age (Participant Must be between 16 - 24 years of age)
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Month
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Day
Year
Date
Are you part of a DYCD-funded program or other community youth group ?
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Please Select
DYCD-funded program
Other organization
None of the above
Why are you interested in becoming an MBSKYC representative? *
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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).
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Yes
No
Are you able to travel to throughout the City (Brooklyn, Bronx, Queens, Manhattan, Staten Island)for meetings with their peers and provide HUB support?
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Yes
No
Are you able to participate in weekly Council Meetings and attend “Super Saturday” training?
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Yes
No
Are you able to work closely with other members to complete action plans developed by the council?
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Yes
No
Are you able to participate in weekly Council Meetings and attend “Super Saturday” training?
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Yes
No
If you have the opportunity to present your recommendations and ideas to local leaders, what would you want your local leaders/officials address?
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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?
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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.)
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Environment
Voter Registration
Gun Violence
Bias and Prejudice
Bullying
Food Justice
Education
Equality
Health
Human Rights
Gang Violence
Animal Rights
Other
Are available to participate in My Brothers Sisters Keeper Youth Council (1) Day - Overnight Leadership Retreat on October 13th - 15th, 2023?
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Yes
No
Maybe
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.
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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.
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Reference 1
Reference 2
Name
Email
Telephone
Relationship to you
Parent Name
*
First Name
Last Name
Parent Contact
*
Please enter a valid phone number.
Parent Email
*
example@example.com
Is there anything else we should know?
Submit
Should be Empty: