2024 Manice Education Center: BRIDGE Registration Form

Christodora's Manice Education Center BRIDGE Program is open to high school students, 16 years of age or older, who are residents of New York City and have completed session 4.

Program Information

Program Year

2024

Applicant Type

Returning

Program Term

Summer

Returning Camper Info:

Student First Name

Student Last Name

Age

Birthdate

Gender (Check One)

FemaleMaleOther

School Name

Current Grade (2023-24)

Partnering Program Name

Camper's Email

Camper Cell Phone

Home Address

Home Address

City

State

Zip Code

Optional:

You most identify with (check all that apply):

African American/Black (including Africa & Caribbean)Hispanic/Latino (including Spain)White (including Middle Eastern)Asian (including Indian subcontinent & Philippines)Native American (including all Original Peoples of the Americas, HI, or AK)

Please answer the following questions:

Do you have any other summer plans that might cause a scheduling conflict with the session that you're interested in? (For example: summer school, summer job, family vacation, etc.? ) What sessions of MEC have you attended prior to this year?

Describe why you would like to participate in the BRIDGE Program.

What do you think will challenge you? What would you like to learn?

PRIMARY Guardian/Parent Info. Guardian/Parent must provide e-mail, phone number, or both:

Primary Legal Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Home Phone

Parent/Guardian Cell Phone

Parent/Guardian Work Phone

Language(s) Spoken by Parent/Guardian

SECONDARY Guardian/Parent Info

Secondary Legal Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Home Phone

Parent/Guardian Cell Phone

Parent/Guardian Work Phone

Language(s) Spoken by Parent/Guardian

Please review your application before submitting your form. If you have any issues submitting the form please contact the Admissions Team: admissions@christodora.org or (212) 371-5225.

Contact Information