AIEA Protecting Our Land registration
Event Timing: July 27 - 30, 2017
Event Address:James 4-H Camp, Mingus Valley in Prescott, Arizona
Contact us at (602) 258-4822 or IndigenousStrategies@gmail.com
Participant's Full Name *
Your answer
Primary Email *
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Alternate Email
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Tribal Affiliation(s) *
Your answer
School District *
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School Name
Your answer
Grade Level *
Parent/Caregiver Name *
Your answer
Parent/Caregiver Phone Number *
Your answer
Parent/Caregiver Email Address
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Emergency Contact Name *
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Emergency Contact Phone Number
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Payment Information
Payment is $75.00 which includes four days and three nights of lodging at the James 4-H Camp. Meals include dinner on the first day, three meals on the second and third day and breakfast on the last day. Attendance at all four days is expected.
Payment Method *
Purchase Order Number
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Name of Purchase Order staff
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Are you interested in a Scholarship? *
Scholarship Question 1: What leadership roles have you held? Have you participated in any community-based projects/events focused toward change? If so, describe it.
Your answer
Scholarship Question 2: What interests do you have about tribal events that have changed the direction of your people? (i.e. history, issues, laws/policies, etc.)
Your answer
Scholarship Question 3: What does Environmental Stewardship mean to you?
Your answer
Scholarship Question 4: What does “ways of learning” mean to you? “Traditional ways of knowledge”? Please explain. (i.e. strategies, methods, learned skills, etc.)
Your answer
Dietary restrictions *
Other Specials Needs
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T-Shirt Size *
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