StAMINA Youth Conference Registration
Thank you for your interest in the Student Alliance for Mental Health Innovation and Action (StAMINA) conference. This conference, which is free of charge, will take place at the Olmsted on Tuesday, March 13th, from 5 to 8 p.m.

This conference, open to all youth in Kentucky aims to increase mental health awareness and decrease stigma among students. Come for fun activities, group discussions, and delicious complimentary refreshments!

Please fill out this short registration form and email us at with questions, comments, or concerns.

Email address *
Full name *
Please include your first and last name.
Your answer
Phone number *
Please list your personal phone number, not a parent's
Your answer
Address *
Please include street address, city, and zip code.
Your answer
What is your grade level? *
Do you have any allergies or dietary restrictions? If so, please list them here. *
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms