AYM Group Registration
AYM Conference - Saturday, November 10, 2018 at Pasadena City College

Registration & Payment Deadline: Friday, October 12, 2018
Deadline may close at an earlier date
No refunds & No cancellations will be accepted after this date
**REMINDER: To complete your registration you must submit a purchase order or payment by Friday, October 12 by 5:00pm.**

Please make check payable to Adelante Youth Alliance
Mail your check to:
Adelante Youth Alliance
P.O. Box 92517, Pasadena, CA 91109

**There is no online payment option.**

School / Organization / Program Name: *
Your answer
What is your School District *
Your answer
Contact Name: *
Your answer
Contact Position / Title: *
Your answer
Address Line 1: *
Your answer
Address Line 2:
Your answer
City: *
Your answer
State/Province: *
Your answer
ZIP/Postal Code: *
Your answer
Office Phone: *
Your answer
Cell Phone:
Your answer
Fax:
Your answer
Email: *
Your answer
Number of Student / Youth Attendees: *
Your answer
Number of Adult Attendees: *
Your answer
Total Number of Attendees:
Your answer
Do You Need An Invoice? *
Comments:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms