Native Youth Community Adaptation and Leadership Congres

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

2020 Native Youth Community Adaptation and Leadership Congress
Application: DEADLINE APRIL 17, 2020

Join students from across the country to discuss community adaptation and related environmental issues impacting Native peoples. The mission of the Native Youth Community Adaptation and Leadership
Congress (NYCALC) is to develop future conservation leaders with the skills, knowledge, and tools to address environmental change and conservation challenges to better serve their schools and home
communities.
2020 NYCALC DATES: June 26 - July 3, 2020
STUDENT APPLICANTS: BEFORE CONTINUING, PLEASE READ THE BELOW LINK FOR DIRECTIONS AND A PREVIEW OF THE APPLICATION QUESTIONS:
https://docs.google.com/document/d/1TnLftj4Aa2gwFKzrZ3Xd3LN5Ep0cV8prmu6aGWDIOPk/edit?usp=sharing
MENTORS: PLEASE HAVE FULL LIST OF APPLYING STUDENTS PRIOR TO FILLING OUT THE APPLICATION.
Only teams composed of a minimum of 3 to a maximum of 5 students will be accepted from a single community. All students will fill an application out individually.
HAVE A QUESTION? Please check out our Frequently Asked Question sheet at the link below:
https://www.nycalc.org/faqs
Or you may contact [email protected] /(505) 299-5404.
DEADLINE: April 17, 2020
PRIVACY ACT STATEMENT:
Authority: The information requested is authorized by the Government Organization & Employee Training Act (5 U.S.C. 4101, et seq), Executive Order 11348 (Providing for Further Training of Government
Employees), Americans with Disabilities Act and the E-Government Act of 2002, (42 U.S.C. 112101) and the E-government Act of 2002 (44 U.S.C. 3501).
Purpose: To enroll students for National Conservation Training Center (NCTC) hosted programs.
Routine Uses: The information on this form may be used by program leaders to contact those selected for the NYCALC program. Information may be disclosed to the Department of Justice (DOJ), a court,
adjudicative or other administrative body, the fiscally sponsoring organization or agency of the student, a party in litigation before a court or adjudicative or administrative body; or any DOI employee when
represented by DOI or DOJ for legal proceedings or as required by law pursuant to the routine uses identified in the System of Records Notice: DOI Learn, Interior – DOI-16.
Disclosure: Providing the requested information is voluntary. However, failure to provide the information may prevent participation in the program.
* Required

1.

Select one

Email address *

2.

You are now entering the Mentor form. It is a series of agreements to your roles and responsibilities throughout the Native Youth

Are you a *

Mark only one oval.
Student

Skip to question 3

Mentor
Skip to section 3 (You are now entering the Mentor form. It is a series of agreements to your roles and responsibilities throughout the Native Youth Community and
Adaptation Congress process. If you have any questions throughout the form please reference the roles and responsibilities section in the FAQ sheet. )

Community and Adaptation Congress process. If you have any questions throughout the form please reference the roles and
responsibilities section in the FAQ sheet.
Skip to question 32

Student Information
3.

Student Application

First and Last Name *

As it would appear on official documentation, such as social security, license, passport

4.

You are applying to the Native Youth Climate and Leadership Conference. Please fill out the following answers to the best of your

Preferred Name/Nick Name
5.

ability. Please note that the 2020 Congress is only accepting groups of 3-5 students from a single community, high school, or other

Email *
6.

youth organization. If more than 5 students apply, we will accept the top applicants from each group. We are only accepting groups to

Your City *
7.

encourage teamwork and build student networks before and after the Congress. Please continue to the individual application. Best of

Your State *

State abbreviation. Ex. WV, ND, VA

8.

luck!

Your tribal/community/corporation affiliation: *
9.

Student Application Pt. 1

Local Hometown/Community Newspaper/Outlet
https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

Please fill out this short answer section as completely as possible in the space provided. Please write anything you find relevant within your lifetime.

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

10.

Student Application Pt. 2
Answers should be written as paragraphs.

Phone number *

Please write your number in the following format: (XXX) XXX-XXXX

11.

Student Application Pt. 3 (Final)
When brainstorming a conservation-based project consider your passions, skill sets, and your community's needs. Please outline your idea with the following format.*This can be a group or

Phone type *

Mark only one oval.
Cell
Home
12.

individual answer.*
Skip to section 17 (Thank you for completing the NYCALC 2020 application! Please submit form now.)

Are you... *

for rooming organization purposes only.

Mark only one oval.
Female
Male
Other:
13.

Mentor Information

School Name *
14.

Mentor Information

School Location *

City, State, Zip Code (ex: Shepherdstown, WV, 25443)

15.

Mentor Agreements

Grade for the 2020-2021 School Year *
Mark only one oval.
11th
12th
16. Mentor Agreements

Full Name of Mentor *

First and Last name. In naming this mentor, you should have already spoken with them and reviewed together the information on the Congress.

17.

Mentor Agreements

Mentor Nickname/ Preferred Name

18.

Mentor Agreements
Please read through and check all individual boxes. Refer to the manual for questions.

Extracurricular activities, school clubs or organizations you currently participate or have previously participated in (ex: spiritual groups,
sports, activism, recreational activities, performances):

19.

Mentor Agreements
Please read through all and agree by selecting each task.

Community organizations you are/have been a part of:

20.

Thank you for completing the NYCALC 2020 application! Please submit form now.

Volunteer experience (ex: Food Bank, donation drives, community clean-ups, etc):

https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

21.

Accomplishments or awards you have received and what year/semester:

22.

Other strengths, qualifications, and/or obstacles you have overcome you would like the application reviewers to consider:

23.

What does "nature" mean to you and how/when do you feel connected to it? Why do you want to connect people to nature? *

Nature creates, provides, and sustains life. The earth’s natural resources are what support all of the ecosystems and organisms on the planet and should be preserved and respected. Exposing people to nature
and teaching them of its importance can encourage future interest and stewardship of the environment. We (all people) need current and future generations to understand and respect the natural world in order
to combat issues that we face in the modern world such as climate change, species habitat loss and fragmentation, lack of resources (available clean water, air, food) to support humans and wildlife…

24.

Have you ever used your personal story to inspire change? *
If you have, give an example. If not, give a reason why that is the case.

25.

Tell us of one environmental problem you see in your community and where you believe the solution lies. *

Give some concrete steps that you could possibly take to work towards said solution· Examples: Lack of connection with the environment and thereby decreased stewardship/conservation· Dependency and
comfort in technology and unfamiliarity with disconnecting and experiencing things independently firsthand, especially with the next generation

26.

What steps do you take to ensure you continue to grow and develop as a leader? *

27.

Project Goal and Summary *

28.

Who is your audience? Why are they important? *
https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

29.

How would you implement this project, and what tools would you need to be successful? *

30.

Would you need additional support (ex: volunteers, other schools, professionals, neighboring communities)? *

31.

When would your project be completed? Is it a one-time project or ongoing over many years into the future? *

32.

First and Last Name *

As it would appear on official documentation, such as social security, license, passport

33.

Preferred Name/Nick Name
34.

Email *
35.

Your City/Town *

36.

Your State *

Sate abbreviation. Ex: WV

37.

Your tribal/community affiliation: *
38.

Local Hometown/Community Newspaper/Outlet
39.

Phone number *

Please write your number in the following format: (XXX) XXX-XXXX

https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

40.

Phone type *

Mark only one oval.
Cell
Home
41.

Are you *

for rooming purposes only.

Mark only one oval.
Female
Male
Other:
42.

How many students are applying from your community? *

Mark only one oval.
3
4
5
6
7
8
9
10
43.

List of Student Names *

ONLY SUBMIT application if this information is known. Mentors may have to fill out the application after recruiting students and compiling names of those applying. Please use official names as they would
appear on documentation and follow this format: 1. Jane Doe, 2. John Doe, 3. Jack Doe (etc.)

44.

Relationship to students *
Mark only one oval.
Mentor
School Counselor
Teacher
Youth Leader
45.

I accept responsibility for assisting interested student groups in the application process, clarifying application requirements for those
individuals, and providing both students and parents notice of acceptance/non-acceptance. *
Check all that apply.

Agree
Other:

46.

I will coordinate the delivery and receipt of all required forms and documentation, attend pre-Congress informational webinars,
communicate with the travel coordinator in ensuring travel is in place for students, and distribute needed information to all students and
guardians. *
Check all that apply.

Agree
47.

I will attend webinars/online training to review roles and responsibilities, the agenda, staffing plans, and receive cultural/generational
training before the Congress. These meetings will be provided by NCTC and NYCALC staff, will give mentors necessary information and
tools for the Congress, and serve as an opportunity for questions and guidance. *
Check all that apply.

Agree
48.

https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

During the Congress, I will..... *
Check all that apply.

Greet the students and help orient them to NCTC
Attend daily staff meetings
Engage with all participants and visitors to create a strong network
Facilitate OST sessions as needed
Provide guidance and support to JR Faculty and students
Assist in curfew enforcement as needed
Remain engaged with students both during and post-Congress
49.

After the Congress I will... *
Check all that apply.

Ensure students arrive home safely
Provide aid and encouragement to submit their grant proposals
Provide students with assistance and ongoing mentorship throughout the implementation of projects

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 Forms

https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]

2020 Native Youth Community Adaptation and Leadership Congress Application: DEADLINE APRIL 17, 2020

https://docs.google.com/forms/d/1ljQu1BRoMZkfMQb38QKKoickxZ6EduW76xbk_sS_1as/printform[6/23/2020 2:04:02 PM]