Teen Ink: New York City Summer Program - 2012

Teen Ink New York City Writing Program Application, June 23 - July 7, 2012

Since Teen Ink usually receives many more applications than we can accept, we suggest you complete the application now if you are seriously interested. Your essays and recommendations should follow soon thereafter since we try and accept students on a rolling admissions basis until the program is full.

Please complete all the fields below:

First Name:
Middle Name/Initial:
Last Name:
Nickname:
Address:
City:
State:
Zip:
Your Email:
Teen Ink does not give or sell email addresses to other organizations.
Date of Birth:
Gender:
Grade:
Home Phone:	()
Cell Phone:	()
School Name:
English Teacher's Name:
School Address:
School City:
School State:
School Zip:
School Phone:	()

Mother (or Legal Guardian):
First Name:
Last Name:
Relationship to You:
Mother's Home Address (if different from above):
Daytime Phone:	()
Evening Phone:	()
Cell Phone:	()
Mother's Email:

Father (or Legal Guardian):
First Name:
Last Name:
Relationship to You:
Father's Home Address (if different from above):
Daytime Phone:	()
Evening Phone:	()
Cell Phone:	()
Father's Email:

Have you ever been away from home for more than a few days at a time?

If yes, when, where and for how long?

What are your hobbies and/or interests?

What genre of writing interests you most?

Poetry
Fiction
Memoirs
Journal Writing

Please check one box below to acknowledge that you have discussed this program with your parents, shown them the email with all the information and have their permission to apply.

Yes, my mother and/or father are aware of my application. They have reviewed the program and costs involved, and will let me go if I am accepted.
No, I have not yet discussed this with my parents.