Form Online (Web) Form Online (Web) Form Native Youth Community Adaptation and Leadership Congres

OMB Control No. 1018-0176

Expires 02/29/2024

Native Youth Community Adaptation and Leadership Congress

Application Preview and Directions

Thank you for your interest in NYCALC 20##! The online application should be filled out individually by each student. From a single community teams composed of a minimum of 3 to a maximum of 5 students will be accepted so please fill out the application to the best of your ability! Below is a preview of the application questions. The application, once opened, cannot be revisited to edit or complete at a later date. WE STRONGLY ENCOURAGE TO REVIEW AND WRITE YOUR ANSWERS PRIOR TO OPENING THE APPLICATION. YOU CAN COPY AND PASTE YOUR PRE-WRITTEN ANSWERS INTO THE APP.

The application is divided into four sections.

• The first section is called Student Information. This is your basic personal information (Name, Nickname, Birthday, Community/Tribal Affiliation, Address, Phone, Mentor Name, School Name and Address, Grade, Email).

• Part One is a short answer portion to the following questions. These questions are designed to gain insight into how involved you are in your community and school life.

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

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

2. Community organizations you are/have been a part of:

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

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

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

The answers for this portion are not required, but should be filled out to the best of your ability to strengthen your application. You may write lists for this section.

• Part Two is comprised of essay questions that should be answered with no less than 1000 characters (a standard paragraph).

1. 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…

2. 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.

3. 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 first hand

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

After this section you will continue to the final question.

• Part Three is a project outline. This portion should be a preliminary project idea that will be developed throughout the Congress. At NYCALC you have the opportunity to potentially earn a mini grant to help put it into action upon return from the Congress. THIS IS THE ONLY PORTION THAT CAN BE COMPLETED AS A GROUP. IT CAN ALSO BE COMPLETED AS AN INDIVIDUAL. Answers should be complete sentences.

Directions: When brainstorming a conservation-based project consider your passions, skill sets, and your community's needs. Please outline your idea with the following format.

1. Project Goal and Summary

2. Who is your audience? Why are they important?

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

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

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

NOTICES

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.

Paperwork Reduction Act Statement

We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501 et seq.) to assure the health and safety of participants while on site at the National Conservation Training Center for the Congress. Your response is voluntary and we will not share your response publicly. We may not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB Control Number. OMB has reviewed and approved this focus group and assigned OMB Control Number 1018-0176.

Estimated Burden Statement

We estimate it will take 4 hours to complete the application form and 30 minutes to complete the medical information form, including time to read instructions and gather information. You may submit comments on any aspect of this information collection to the Service Information Collection Clearance Officer, U.S. Fish and Wildlife Service, 5275 Leesburg Pike, MS: PRB (JAO/3W), Falls Church, VA 22041-3803, or via email at [email protected]. Please do not send your completed form to this address.