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New York State YMCA Youth and Government Legislative Program Sign-Up
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Your School or YMCA
(Required.)
Acton Academy Syracuse
Albany High School
Averill Park High School
Baldwinsville Baker High
Bethlehem Central High School
Bolton Central School
Brighton
Canisius High School
Cazenovia high school
Center Moriches High school
Charles W. Baker High School
Christian Brothers Academy
Columbia High School
Coxsackie Athens High School
Durgee Jr. High School in Baldwinsville
Emerson J Dillon Midde School
Elmont
Fairport
Fayetteville-Manlius High School
Forest Hills High School
Frank Sinatra School of the Arts High School
Genesee Valley Central School
Homer Senior High School
Homeschool
Hudson Valley Community College
Jamesville-Dewitt High School
John Bowne High School
Johnsburg Central School
Keshequa
Liverpool
Liverpool Middle School
Long Island City High School
Manlius Pebble Hill School
Marlboro High School
McQuaid
Mechanicville High School
Mercy
Middletown High School
Midwood High School
Millennium Brooklyn High School
Minerva Central School
Newcomb Central School
North Rockland High School
North Warren Central School
Notre Dame Bishop Gibbons
Nyack Senior High School
Pearl River High School
Pierson
Queens High school for Language Studies
Queensbury High School
Ray Middle School
Schenectady High School
Shaker High School
Shenendehowa High School
Solvay
Southampton High School
Staten Island Academy
Stuyvesant High School
Tappan Zee High School
Wellwood/Fayetteville Manlius
Westhampton Beach High School
White Plains High School
William Floyd High School
Other(School not listed)
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4.
Your Current Grade
(Required.)
12
11
10
9
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6
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5.
How many years previously have you participated in the Youth and Government Program, not including this year?
(Required.)
This is my first year
1
2
3
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6
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6.
Your Cell Phone Number, or main contact phone number. Please include only the numbers, no hyphens or parentheses. For example please enter 5551234567 not (555) 123-4567
(Required.)
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7.
Your Email. Please make sure it is spelled correctly, as this will be the way you receive communication about the program. Please do not use a school based email address, as most have strong filters and often filter out our emails.
(Required.)
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8.
If you already know what you want to work on a bill about, please explain your ideas, or ideas, if you have multiple. This will be published for others to view and possibly indicate interest in working with you. Your contact information will not be shared with anyone.
(Required.)
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9.
Please Indicate your level of Interest in the following topic areas. This information will be used to help find you potential Bill partners and may be made public.
(Required.)
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Agriculture
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Children and Family Services
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Consumer Protection
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Correctional Services
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Economic Development
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Education
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Environmental Protection
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Health and Human Services
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Housing and Urban Development
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Labor
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Public Safety
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Taxation and Finance
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Transportation
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Equity/Inclusion
1 - Least Interest
2
3
4
5 - Most Interest
I do not wish to work on this topic
Please let us know of any specific requests, issues, or other considerations you feel relevant. Anything written in this box will not be shared.
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