Athlete Leadership Conference Application- GLOBAL MESSENGER
When: September 18-19 2020 (5pm Friday-5pm Saturday) Registration Closes: August 24, 2020 Where: Baymont Inn & Suites 6221 Willow Creek Ave Des Moines IA 50321
I am a: *
If NEW, list who nominated you to apply to become a Global Messenger and what their relationship to you is.(Parent, Coach, Teacher, Area Director, etc.)
Your answer
Athlete/Unified Partner First and Last Name *
Your answer
Athlete/Unified Partner Address *
Your answer
Athlete/Unified Partner City *
Your answer
Athlete/Unified Partner State
Your answer
Athlete/Unified Partner Zip Code *
Your answer
Athlete/Unified Partner Email Address (If ATHLETE does not have an email address put NA)
Your answer
Athlete/Unified Partner Home Phone Number (Put NA if no land line phone, if ATHLETE does not have a home phone put NA) *
Your answer
Athlete/Unified Partner Cell Phone Number (Put NA if no cell phone, if ATHLETE does not have a cell phone put NA) *
Your answer
Athlete/Unified Partner Shirt Size (Unisex sizes- tend to run big) *
Athlete/Unified Partner Birthdate *
MM
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DD
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YYYY
Does the applicant use a wheelchair? *
Please list all FOOD allergies (Put NA if you don't have any) *
Your answer
Who will be attending with you to serve as your speech coach? *
Your answer
Best way to contact you for events (Check all that apply) *
Required
Would you like a hotel room? (Limited space available, will be reserved for those coming from outside Des Moines area first. Those in the Des Moines area can be put on a waiting list to see if rooms are available.)
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