Louisiana Y&G Interested Party Submission

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Spoken to one of our delegates, program staff, or just word of mouth? Have a passion for speech, debate or civic engagement in the local, state, national or international arenas? Interested in joining a student-led movement going on 55 years in Louisiana? You're in the right place. Please complete the short form below so our Club Development staff can properly assist you in starting a club at your school or helping you get to one of our conferences.

If you have any questions, please don't hesitate to contact:

Eddrick Martin
emartin@ymcabr.org

Taylor Dizor
taylor.dizor@gmail.com

First Name *

Last Name *

Phone Number

E-mail *

School *

City *

Region *

Party Status *

Student

School Administrator

Parent

Other:

If you selected an option associated with a school, what is your current position?

How can we help you?

What have you heard about our program?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms