Journey into Leadership: Oh the Places You'll Go!
16th Annual WV TRIO Student Leadership Conference
Deadline
Registration must be completed by February 24th, 2017
Cost
The conference registration fee covers ALL meals, entertainment and conference materials.
 The cost is $100 per person for registrations received by February 24th, 2017.
 Registrations received after February 24th will be charged at a rate of $150 per person.
 Refunds, minus a $25 administrative fee per registered attendee, are available through
March 1st, 2017.
 No refunds will be issued after March 1st!
General Information
Contact Person
Your answer
Contact Email
Your answer
Contact Person Office Phone Number
Your answer
Contact Person Office Cell Number
Your answer
Institution
Your answer
Program
Required
Provide a mailing address for your program/organization:
Your answer
CHAPERONES
Each program must have a minimum of one chaperone for every 10 students. All chaperones are required to register for the conference and must attend events with his/her students. Chaperones are responsible for the actions of their attendees!
Please list the names of chaperones that will be in attendance. Hit ENTER after each name.
Your answer
Please list shirt sizes for ALL chaperones attending the Student Leadership Conference. Shirt sizes available are: Small, Medium, Large. Extra Large, XXL and XXXL.
Your answer
Please list the dietary needs or accommodations for any chaperones in attendance. Type N/A if no accommodations are needed.
Your answer
STUDENT REGISTRATIONS
Please complete the information below for our records. If you make changes to the students who will be attending after February 24th, we can not guarantee that shirt size accommodations can be made.
Please list the names of program participants that will be in attendance. Hit ENTER after each name.
Your answer
Please list shirt sizes for ALL program participants attending the Student Leadership Conference. Shirt sizes available are: Small, Medium, Large. Extra Large, XXL and XXXL.
Your answer
Please list the dietary needs or accommodations for any program participant in attendance. Type N/A if no accommodations are needed.
Your answer
Group Photo
We are excited to offer the opportunity for each program to have a group photo taken in front of a green screen with the TRIO Logo and/or Conference Logo. You will receive your photo immediately to take back and share with your students. To be efficient, we want to have a scheduled time for each group so that long waits do not occur. With this in mind, please select your top three time choices below and we will inform you of your scheduled time prior to the start of the conference.
Please indicate your top three schedule choices for a group photo:
Required
Payment
Please indicate how you will be paying for your attendance at the conference. An invoice will be sent based on your final number of conference registrations.
How will you be paying?
Submit
Never submit passwords through Google Forms.
This form was created inside of Heart of Appalachia Talent Search Program. Report Abuse - Terms of Service - Additional Terms