5th Annual Black Youth Leadership Summit Student Registration Form
Please complete the following registration form in order to participate in the 5th Annual Black Youth Leadership Summit. BYLS is happening on the SOU campus on Feb. 23, 2023, 9 AM - 2:45 PM. 
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Email *
First Name *
Last Name *
Birthday *
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School District *
School *

Grade
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Address *
City *
Zip *
Phone Number  *
Parent or Guardian Name *
Parent or Guardian Phone Number *
Email *
Parent or Guardian Email *
Do you have any food allergies?  *
SOU strives to be an inclusive campus that serves all visitors. Do you have need for additional support in order to participate fully? These could be due to hearing, vision, access, or other needs.  *
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