2024-2025 Community of Rising Environmentalists Application Form
Program Information
Program Year
Please select...
2024
Program Term
Please select...
Fall
Christodora's 2024- 2025 Community of Rising Environmentalists (CoRE) is open to all New York City
middle and high school students.
Student Info:
Student First Name
Student Last Name
Age
Birthdate
Gender (Check One)
Male
Female
Other
School Name
Current Grade
Please select...
6
7
8
9
10
11
12
If applicable, what is the name of the program or school that helped you apply? (Example: Winter Ecology Program, Manice Education Center, M.S 123 etc.)
Student Email (if you do not have one, please list your parent/guardian's email address)
Student Cell Phone (i
f you do not have one,
please list your parent/guardian's phone number)
Home Address
Home Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
PRIMARY Guardian/Parent Info:
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
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)
Other
How did you hear about Christodora?
(Please check all that apply)
Winter Ecology Program (educators were directly in your classroom during the school year)
3-day Field Trip to the Manice Education Center with your school
Summer Camp Session at Manice Education Center
Summer Ecology Program
Recruitment event or camp fair
Online/social media search
Friend, family member, or educator told you about it. If so, please list their full name(s) below:
Please answer the following questions:
Why do would you like to join the Christodora's Community of Rising Environmentalists (CoRE)? What would you like to accomplish by participating in this program?
Have you worked in a group before? What excites you about group activities?
To respect the groups progress and to get most out of this experience, we expect registered participants to commit to attending to each Saturday program from September 14 to December 21. Generally speaking, are you available on Saturdays from 11 AM to 3 PM?
Yes
No
Please review your application before submitting your form.
If you have any questions please contact the Admissions Team at 347-468-2878 or Admissions@christodora.org
Contact Information