Student Application

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Contact Information

Full Name*
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Mailing Address*

Application Details

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Have you ever been accused/convicted of a felony?*
Do you have Experience in Volunteer Settings?*
Would you travel to an adjacent city/county for your program?*
Typically, MyPI participants join a cohort group in the communities where they reside. However, in the event that we are not able to fill a cohort of 18 to 24 teens from your area, there may be opportunities for you to join a cohort in an adjacent community.

Thank you for your interest in MyPI. If you have any questions/comments, please feel free to contact Mr. John Bowe, MyPI New York, State Program Manager at (518) 668-4881 or at

Applications will be evaluated by the MyPI Administration. Official notification of selection will take place as soon as possible after reviewing and verifying information. Early submission of MyPI Participant Application and Information Form is strongly encouraged.

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