2017 Student Registration Form

All students must complete this form by September 28, 2017. You must be in a delegation and complete all required fields to register for the program. You also must turn in the Student Participation Agreement Signature Page and Medical Form to your delegation director.

    PROGRAM AREA

    Select the program area you plan to participate in at the State Convention. All 9th grade students in the Legislative branch will be in the Novice House. All 8th grade participants will be in the Civic Leadership Institute.
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    DELEGATION

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    STUDENT INFORMATION

    Please enter the following information. Your PREFERRED NAME will be used on your nametag.
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    CONTACT INFORMATION

    Be sure to enter accurate information so YAG can keep in contact with you about the program prior to the State Convention.
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    Must be a valid email address
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    PARENT/GUARDIAN INFORMATION

    Please enter information for a parent/guardian as an emergency contact for you.
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    Must be a valid email address
    This is a required question
    This is a required question