Shore Corps Program Online Registration Form

Any student who will be in high-school (9th-12th grade) in the 2018-2019 school year is eligible to apply.

Form fields with * are required to register.
Please contact us if you have any questions.

Program Information

Student Information

Month / Day / Year

Example: 718-555-1212

Email is the primary means of communication throughout the program. Be sure you check the email address you provide to us frequently. For Shore Corps and Environmentor, teens will be the point of contact for all program communication. Parent/Guardians will be copied upon request. Please do not use Scholar's Academy email addresses. If you do not have regular internet access, please let us know and we will work to accommodate you.

For summer, put your rising grade.

Emergency Contact 1

Emergency Contact 2

About You

Month / Year