Lobbyist Registration Form

Please only submit one form. Please provide valid email addresses or you will be unable to complete the registration process.


School:

Any delegates wishing to be a member of the Lobbyist Component MUST complete this registration form. Assignments will be made on a first-come, first-serve basis. Please be sure to submit these registration forms ASAP. Lobbyist must have participated in YIG for at least one year prior to serving in this conference.


First Name: A value is required.Last Name: A value is required.Gender: Please select an item.
Address: A value is required.City: A value is required.State: A value is required.Zip: A value is required.Invalid format.
Birthday:
Please select an item. Please select an item. Please select an item.		Cell Phone: A value is required.Invalid format.Grade: Please select an item.
Parent Name(s): A value is required. Home Phone: A value is required.Invalid format.Parent Email: A value is required.Invalid format. Parent Cell Phone: A value is required.Invalid format.
T-Shirt Size: Please select an item.Student Email: A value is required.Invalid format. Years at YIG (if first year put 1)

You may need to wait up to 1 minute for your form to process, please do not click submit more than once.

Please note, the information contained in this form will be sent for verification to all of the email addresses (parent and student) provided in the form above.

After pressing submit, scroll up to see if you have incorrectly completed any fields (they will be highlighted in red)