How to Apply

Please allow approximately 30 uninterrupted minutes to complete your application, as you cannot save your progress.

Scholarship applications are available and participation qualifies for service learning credit. For those interested in financial assistance, our scholarship application form can be found at the end of this page.

Our 2016 program runs August 15–26, with one overnight on August 19. The cost of the program is $1,800. Please allow for up to two weeks for review of your application. A minimum deposit of $450 will be due upon acceptance, and the remaining payment will be due by June 24, 2016. For questions, contact us directly at popupforchange@14streety.org or 646.395.4355. 

General Information
Name *
Name
Date of Birth *
Date of Birth
Address
Address
Parent / Guardian 1
Name *
Name
Phone *
Phone
Parent / Guardian 2
Name *
Name
Phone *
Phone
We want to learn more about you. Please answer two of the following four questions:
PLEASE COMPLETE ALL REMAINING QUESTIONS
You do not have to be Jewish to answer this question.
Are you applying for scholarship? *
See details below.
This form has been reviewed by my parent or guardian. *

Scholarship Application

Once you have submitted the above application form, if you are interested in financial assistance please provide a scholarship application, along with a copy of your family’s 2015 or 2016 tax return.

You can email these materials to nspierer@14streety.org or send via mail to 14th Street Y, 344 East 14th Street, New York, NY 10003, Attn: Jenni Sussell.

We will notify scholarship recipients in May. If a scholarship is not awarded, your deposit may be refunded.