WASHINGTON LEADERSHIP CONFERENCE
IOWA FFA BUS GROUP--Week 2
REMEMBER: The Iowa WLC Bus Trip is June 12-18. The total registration cost is $1170: $850 student registration and $320 for travel. SUBMITTING THIS FORM COMMITS THE MEMBER/CHAPTER TO THE REGISTRATION EXPENSES ASSOCIATED WITH THE TRIP. Invoicing for the trip will occur in late May. Please note that most of the information requested below is what is required on the National FFA registration that is submitted by the state. Please submit ONE form for EACH member - Thank You!
Chapter Information
Boarding Location *
Chapter Name *
Your answer
Chapter ID (Ex: IA0412) *
Your answer
Advisor Name *
Your answer
Advisor Email *
Your answer
Advisor Cell Phone *
Your answer
FFA Member Information
Member First Name (ex: Jonathon) *
Your answer
Member Preferred Name (ex: John) *
Your answer
Member Last Name *
Your answer
Member's Address: State *
FFA Membership ID (ex: 600812389) *
Your answer
Member Email Address (type carefully!) *
Your answer
Gender *
Polo Shirt Size *
T-Shirt Size (Unisex Sizing) *
Member Cell Phone Number *
Your answer
Emergency Contact Information
1st Emergency Contact Person Name *
Your answer
1st Emergency Contact Person Number *
Your answer
2nd Emergency Contact Person Name *
Your answer
2nd Emergency Contact Person Number *
Your answer
Other Information/Notes
ADA Information & Needs (Ex: Mobility, Vision, Hearing, Other)
Your answer
Food Allergies
Your answer
Other Special Notes
Your answer
Scholarship Recipient *
If National FFA Scholarship Recipient, enter scholarship code (Ex: ST312)
Your answer
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