Welcome to the 2019 Teen Leadership Summit Scholarship Registration Form
Thank you for your interest in the Peace Academy of the Sciences and Arts! We are about to embark on an incredible journey together.

Safety first! Please supply your information in case we need to contact you or in case of an emergency. Thank you.

Parent's Name *
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Parent's Information:
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Address (Street or PO Box) *
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City, State, Zip *
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Phone *
Cell preferred, please use "xxx.xxx.xxxx" format
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Email *
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Employer *
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