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, RSVP to join a virtual info session with our Admissions Team or visit btny.org/admissions

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 and Level 3+ on the 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. Having as much contact information as possible helps 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 E-Mail
Primary Parent/Guardian Cell Phone

Optional (but Strongly Encouraged):

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

Note: Providing Gender and Race/Ethnicity data helps BTNY lead our nomination and admissions process with an equity lens.

Questions?

If you need any support in using this form, please contact Andrew Lindsay, Director of Admissions, at andrew@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

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.

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

Next Steps

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.