MLK, JR. Holiday Youth Forum Registration
Event Timing: January 21, 2019
Event Address: Douglas County High School
8705 Campbellton St., Douglasville, GA 30134
Contact DCP at
Email address *
Student's Name *
Your answer
Grade *
Gender? *
Dietary restrictions/Allergies *
If you answered yes to allergies, please explain below: *
Your answer
Consent to participate: I grant permission to allow my child to attend the youth forum hosted by the Douglas-Carroll-Paulding Counties Alumnae Chapter. I am aware of the topics that will be discussed during the sessions, and understand the workshops will be conducted by select occupational leaders who are local chapter members of the National Pan-Hellenic Council organization. *
Parent/Guardian Name *
Your answer
Best Contact Number
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