New York State High School Youth and Government Program Intent to Participate

Please contact State Director Drew Caldwell at dcaldwell@ymcanys.org or 270-300-4798 if you have any questions or issues.

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* 1. Full School Name

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* 2. Lead Advisor First Name

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* 3. Lead Advisor Last Name

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* 4. City

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* 5. Lead Advisor Cell Phone/Main Contact Number

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* 6. Lead Advisor Email Address

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* 7. Other Advisor Email Addresses to include on communication.

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* 8. Estimated Number of Students Participating-This is not a guarantee, just your best guess at this point