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
Participant's Full Name
9th grade in 2017
10th grade in 2017
11th grade in 2017
12th grade in 2017
just graduated high school
Parent/Caregiver Phone Number
Parent/Caregiver Email Address
Emergency Contact Name
Emergency Contact Phone Number
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.
Check to ITCA c/o AIEA has been mailed
Purchase Order Number
Name of Purchase Order staff
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.
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.)
Scholarship Question 3: What does Environmental Stewardship mean to you?
Scholarship Question 4: What does “ways of learning” mean to you? “Traditional ways of knowledge”? Please explain. (i.e. strategies, methods, learned skills, etc.)
Other Specials Needs
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