Youth Advisory Council (YAC) Application

All young people in New York City ages 10-18 are eligible to apply to participate in the Youth Advisory Council. Please submit your application by Monday, November 30, 2020 at 11:59 p.m. ET.

* Indicates required fields

First Name*

Last Name*

What are your preferred gender pronouns? You may select from the list below or self-identify. (What's this?)

she/her/hers

he/him/his

they/them/theirs

Self-identify

I prefer not to say

What is your race and/or ethnicity? You may select more than one.

American Indian

Asian

Black

Latina/Latino/Latinx

Pacific Islander

White

Self-identify

I prefer not to say

Date of Birth

Month*

Day*

Year*

Age (on November 30, 2020)*

Phone Number*

Email Address*

Street Address*

Street Address 2

City*

Borough*

Neighborhood*

State

Zip Code*

School/Organization/Other*

Grade*

Please describe why you would be an ideal member of the CCRB Youth Advisory Council (250 words or less)*If you would like to submit a video (1 minute max) or audio recording (1 minute max) instead of a written response, please copy and paste a link to your video or submission in the box below.

How did you hear about the CCRB’s YAC program?

Please check "I'm not a robot" below to verify you are a person.