Student Registration Form

All students must complete the Student Registration Form to participate in the YIG Model Government Program. You must be in a delegation and complete all required fields to register for the program. You also must turn in the Student Participation Agreement and Medical Form to your delegation advisor.

The Student Registration Form must be completed by September 19, 2008. If you have any questions about or trouble with the form, please contact Ken Hussey at khussey@jcymca.org.

Please note the following:

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All items marked with an asterisk (*) must be filled out to complete your registration.

Student Information

* Have you participated in YIG before?	Yes No	Please enter all information. Please indicate if you have PARTICIPATED IN YIG before. This will assist with registering you for the program. Your PREFERRED FIRST NAME will be the name used in YIG correpsondence and on your name tag at the State Convention.
* First Name:
* Preferred First Name:
* Last Name:
* Sex:	Male Female
* Date of Birth:	/ /
* High School Graduation Year:
* T-Shirt Size:

Contact Information

* Street Address:		Please enter your HOME ADDRESS. If you enter a CELL PHONE NUMBER, please indicate if you are willing to receive text messages about upcoming deadlines and other YIG programs. If you enter an EMAIL ADDRESS, you will receive a confirmation email of this registration. Also, you will receive emails about upcoming deadlines and other YIG programs.
* City:
* State:
* Zip:
* Home Phone:	( ) -
Cell Phone:	( ) -
Can YIG send you text messages:	Yes No
Email Address:

Delegation Information

* Select Delegation:

Please select your DELEGATION from the drop-down menu.

Program Selection

* Program Area:

Please select your PROGRAM AREA. A new box will appear below with questions specific to your PROGRAM AREA. Please answer all questions.

Terms of Agreement

* I have reviewed the Student Handbook and Student Participation Agreement. I agree to abide by all the rules and requirements set forth by Missouri YMCA Youth In Government.
	Please check the box indicating that you have read and agree with the above statement. Your registration will not be accepted without checking this box.

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Moot Trial role in 2007:	Attorney Witness Judge None	Please select what role you had LAST YEAR (2007) in the MOOT TRIAL COMPETITION and your preference for THIS YEAR (2008).
Moot Trial role preference for 2008:	Attorney Witness

Only single authors with at least one year of participation in the Legislative Program are permitted to serve in the Senate.	Senate	Please indicate which LEGISLATIVE CHAMBER you would prefer to serve in this year. This indicates your preference but does not guarantee you a spot in the specified chamber.
Both single authors and co-authors may serve in the House.	House
All freshmen and first year YIG participants must serve in the Novice House.	Novice House

Laptop:	Yes No	Please indicate if you have a LAPTOP or DIGITAL CAMERA that you can bring to and use at the State Convention.
Digital Camera:	Yes No

Camera:		Please indicate the type of equipment you have access to that you could use for YIG. If you have a camera, be sure to bring batteries and/or a battery charger for the camera.
Tripod:	Yes No
Hand-held Microphone:	Yes No