Nomination Form

Breakthrough New York (BTNY) is a tuition-free, 10-year program that turns student potential into success. We guide students from middle school through college, helping them gain admission to top high schools and colleges and provide the support they need to graduate and thrive in their careers.

Our 2025-2026 admissions season is currently underway and we’re looking for exceptional 6th grade students to join our program and begin their journey toward college success.

Our nomination process is critical to our admissions outreach, as it allows us to connect directly with a wide group of NYC students who may be eligible for our program.

For more information about BTNY, our admissions and nomination process, and how to support your nominees, visit btny.org/admissions, email admissions@btny.org, or RSVP to join a virtual info session with our Admissions Team.

WHO Can I Nominate for Breakthrough New York?

To be eligible for our program, students must be current 6th graders who:

Live in NYC
Earn 90%+ in core classes (ELA, Math, Science, Social Studies, or equivalent subjects) and Level 3 or higher on the 2024-2025 (5th grade) NY State ELA/Math test
Meet income guidelines (see chart on our website)
Can commit to year-round programming and plan to pursue a four-year college degree

WHAT Information Do I Need to Submit in My Nominations?

You will be asked to submit the following information for each of your nominees. Providing as much contact information as possible is important to help us make sure we can get in touch with students about applying.

Required:

Student Name (First and Last)
Student E-Mail (if available)
Primary Parent/Guardian Contact Information (email, phone number, etc.)

Optional (but Strongly Encouraged):

Student's Preferred Pronouns
Secondary Parent/Guardian E-Mail
Secondary Parent/Guardian Cell Phone

Note: Providing optional data related to students' identities (e.g., gender) helps BTNY lead our nomination and admissions process with an equity lens.

Need more time?

Please note, you can save your progress on this form and return later to finish.

Click "Save my progress and resume later" at the bottom of the form if you need more time to collect information.
When you're ready to continue, click "Resume a previously saved form" and log in with the information you saved.
From there, you can pick up wherever you left off - either to finish filling in nominee details or to submit the form.

Questions?

If you need any support in using this form, please contact Andrew Lindsay, Director of Admissions, at admissions@btny.org or call 917-633-5757.

Nominator Information

School/Organization Name:

Begin typing to search for your school. If your school is not listed, leave this field blank and type your school's name in the "School Name if 'Other'" field below.

School Name if "Other"

Nominator First Name

Nominator Last Name

Nominator's Title/Role:

Nominator's E-Mail Address:

Nominator's Preferred Phone Number

Are you the best point of contact at your school/organization to share updates with on student application progress, upcoming application deadline reminders, etc.?

If you're not the best point of contact within your school/organization, please enter the full name and e-mail address of the best point of contact who we can follow-up with about student applications:

First Name

Last Name

Nomination Submissions

How to Submit Your Nominations

You have two options for submitting student nominations via this form. Please review the instructions below and choose the option that works best for you.

Option 1: Upload a spreadsheet (recommended if nominating 15 or more students)

You will need to download our nomination template spreadsheet.
Enter your nominees' information in the blank spreadsheet.
Upload the completed spreadsheet where prompted on the next page.
Hit submit on this form once you've uploaded the spreadsheet with all your nominees.

Option 2: Enter Nominations Directly in This Form

Select 'Enter nominations directly in this form' as your choice below.
On the next page, you'll be able to enter nominees' information one by one.
Hit submit on this form once you've finished entering all your nominees.

How would you like to submit your nominations?

Submit Nominations via Spreadsheet

To submit your nominations please follow the steps below:

Download the nomination template spreadsheet linked here
Fill in the spreadsheet template with your nominees' information
Upload your completed spreadsheet below

Upload your completed Nomination Spreadsheet here:

By clicking the "Submit" button below, you will be submitting nominations for BTNY. Following submission, our team will begin conducting direct email and phone outreach to your nominees, to encourage them to learn more and apply. Our team will also provide nominators with updates on the admissions status of their nominees.

Nominee Information

Student First Name

Student Last Name

Student E-mail

If the student does not have a personal or school e-mail address, please enter the e-mail address of a guardian.

Student's Preferred Pronouns

Student's Current Grade/Year

6thOther

Borough of Student's Residence

Guardian 1 First Name

Guardian 1 Last Name

Guardian 1 E-mail Address

Guardian 1 Cell Phone

Guardian 1 Preferred Language

Guardian 2 First Name

Guardian 2 Last Name

Guardian 2 E-mail Address

Guardian 2 Cell Phone

Guardian 2 Preferred Language

Report Cards

In our review of Part 1 Applications for BTNY, we will be checking to see if students have at least a 90% or above in their core classes (ELA, Math, Science, and Social Studies).

Do you currently have 6th grade progress reports or 6th grade report cards for your nominees?

YesNo

Please upload the progress report or report cards for your nominees below. If you need to upload more than one file, click the "Add another response" button below.

Nomination Form

How to Submit Your Nominations

If you intend to nominate more than one (1) student please select "Add another response" below to continue adding nominees.