NYSSB Student Application

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This Google form is your application for the NYS Seal of Biliteracy. You will be invited to the NYSSB Canvas page when your application is accepted. To be accepted, you must answer all questions below and submit this form by November 7, 2022. If you have questions or cannot meet the deadline due to extenuating circumstances, please email Emily Ufford at eufford@icsd.k12.ny.us and I will help you.

Email *

Last name(s) *

First name *

In what language(s), other than English, are you applying for the Seal of Biliteracy? List all languages below. (You may apply for a double or triple seal!) *

Are you a heritage speaker of any of these languages? A heritage speaker is someone who learned a language informally by being exposed to it at home. *

Yes

Do you want keyboard stickers for your Chromebook in order to make typing in the language(s) listed above easier? *

Yes

Have you discussed this application and your intent to earn the Seal of Biliteracy with your caregiver? *

Yes

Caregiver name *

Caregiver email (we will include this email in Canvas as an observer) *

School counselor name *

Student ID# *

Month and year of anticipated graduation (one of the requirements to receive the Seal of Biliteracy is graduation from high school): *

From which high school will you graduate? *

LACS

IHS

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