Please answer the questions below. We cannot award scholarships to anyone who does not fully complete this application. Answers must be provided by the applicant. All youth are required to complete this application themselves or with assistance if needed.

Scholarship Information
*If yes, please state the name of the program and nature of affiliation (ex: volunteer, program participant, advocate, etc.)
If yes, please provide a brief statement from the program or network outlining why they would like you to represent them, and the name and phone number of the contact person. Also, please indicate if they can provide any financial support towards your expenses.
I give permission to Families Together to photograph and/or videotape this registered attendee and to use his or her image in photographs, video, and/or film for the purpose of promoting the mission, activities, and programs of Families Together. I understand that this registered attendee and his/her parent/guardian/legal authority is not entitled to any compensation or rights in these materials, and I release Families Together from any liability for the use of this registered attendee's image for the above stated purpose. Please check.
Liability Statement: I have the legal authority to register myself or this youth for this event and I give permission for this youth to attend the University of Youth Power via Zoom. This youth agrees to abide by the rules of the conference. I understand that FTNYS and its staff are not responsible for monitoring this youth and I will not hold Families Together in New York liable in the event of injury.
Code of Conduct: I have chosen to attend this event and will participate in discussions and activities. I will help to create a youth peer community based on mutual respect and a sense of personal well being. I agree to refrain from sexual behavior and public displays of affection while attending the YP event. I will not bring or use any weapons, firearms, or anything that may be construed as a weapon. I will not possess, use, or distribute any illegal drug or drug paraphernalia. I will not commit any illegal activity. I will treat others with honor and respect.