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PR/HYLI 2021-22 Student Application

Student Information / Información del estudiante

All fields must be completed to be considered as an applicant of PR/HYLI / Todas las secciones deben ser completadas para ser considerado como un solicitante de PR/HYLI
1. Are you a part of ASPIRA of NY? / ¿Pertenece usted a ASPIRA de Nueva York? *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
This question requires a valid email address.
This question requires a valid email address.
10. Did you attend the PR/HYLI Information session on October 12 or October 19? 
¿Asistió a la sesión informativa de PR/HYLI el 12 o el 19 de octubre? *This question is required.
This question requires a valid number format.
Please select one of the following images.
19. Are you a returning PR/HYLI delegate? 
¿Es usted un delegado de PR/HYLI que regresa? *This question is required.
20. Can you commit to the following Saturday dates? / ¿Puede comprometerse con las siguientes fechas del sábado?

  8:30am      breakfast / desayuno
  9:00am      start time / hora de comienzo
12:00pm      lunch / almuerzo 
  2:00pm      end time / hora de finalización

November 13, November 20, December 5, December 11, December 18, January 8, January 15, January 22, February 5, February 12  *This question is required.