The Ripple Effect 2K17 Application
By filling in this form, you apply to take part in the AYUDH Americas Youth Summit: "Create. Sustain. Engage.", which will take place from August 2nd - 6th, 2017 at the M.A. Center Chicago. The retreat will begin at 3 pm on August 2nd and will end around 4 pm on August 6th. Check in will begin at 2pm on August 2nd.

We will be in touch with you soon to let you know if your registration has been confirmed. Once you have received a confirmation from us, you can pay using the online registration form we will provide you.

Please take note that the participation fee is $100 for all five days and $80 for any partial amount of time. This fee includes transportation to/from Chicago airports, food, and housing for all five days.

The information contained in this form will be kept confidential and will only be shared with summit personnel on a need-to-know basis.

***Please note that if you are coming from the DC/NYC area, we will be arranging discounted rides in order to accommodate more people. If you are coming from an area highly populated with AYUDH, we will be emailing you regarding possible rides as well.***

If you have any questions or concerns, please email us at!

Thank you for your interest!

Email address *
First Name *
Your answer
Last Name *
Your answer
Age (you are required to be 15 years and older to attend*) *
Gender *
Phone Number *
Your answer
What university do you attend? (if applicable)
Your answer
Have you participated in past AYUDH Summits? *
City *
Your answer
State *
Your answer
Country *
Your answer
Local Chapter (if applicable)
Never submit passwords through Google Forms.
This form was created inside of Email. Report Abuse - Terms of Service - Additional Terms