Middle School Chattanooga 1 House and Senate Registration Form

Please only submit one form per team. You must have all of your team members' information before you can fill out this form. Please provide valid email addresses or you will be unable to complete the registration process.

Chamber:

School:

Bill teams will consist of 2-3 students. Please use a 2:1 ratio of House to Senate teams-2 House teams for each Senate team registered.

Student One:

First Name: A value is required.

Last Name: A value is required.

Gender: Please select an item.

City: A value is required.

State: A value is required.

Grade: Please select an item.

Teacher Email: A value is required.Invalid format.

Student Two:

First Name:

Last Name:

Gender: Please select an item.

City:

State:

Grade: Please select an item.

Teacher Email: Invalid format.

Student Three:

First Name: A value is required.

Last Name: A value is required.

Gender: Please select an item.

City: A value is required.

State: A value is required.

Grade: Please select an item.

Teacher Email: Invalid format.A value is required.Invalid format.

By clicking this box, all delegates listed on this registration form certify they will attend Middle School Youth in Government. Should any delegate choose to withdraw their registration after the Final Deadline, the delegate or school is responsible for the conference fee or for finding a substitute.

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)