Attention!

Please contact FYSB's National Clearinghouse on Families and Youth at (301) 608-8098 if you have questions about this web site. Thank you.

WAITING LIST

Please Confirm Your Information

Please check your registration information below carefully. If there are no errors, print this page for your records and click the Continue button below. If you need to make changes, click )>here , make the necessary changes, and re-submit the form. When you re-submit, you will be shown this page again so you may check your information.

Register By
First Name
Middle Initial
Last Name
Degree
Title
Address
Address 2
City
State	the International"; }else{ print $_POST["state"]; } ?>
ZIP Code
Telephone
Ext.
Fax
E-mail
Special Needs
Age (as of July 28, 2005)  Adviser First Name: "; print " Adviser Last Name: "; } ?>	".$_POST["adult_fname"]; print " ".$_POST["adult_lname"]; } ?>
How would you describe yourself? (Please check all that apply.)
X ',$a_user_type[$i],' '; }else{ echo '    ',$a_user_type[$i],' '; } } // remove end comma $f_user_type = substr($f_user_type,0,strrpos($f_user_type,",")); } //print $f_user_type;die; ?>
Do you attend a program at a
X ',$a_do_you[$i]; if($i==5){ print ": ".$_POST["attendother"].""; } }else{ echo '    ',$a_do_you[$i]; } echo ' '; } // remove end comma $f_attend = substr($f_attend,0,strrpos($f_attend,",")); } //print $f_attend;die; ?>
Do you work for
X ',$a_do_you[$i]; if($i==5){ print ": ".$_POST["workother"].""; } }else{ echo '    ',$a_do_you[$i]; } echo ' '; } // remove end comma $f_work = substr($f_work,0,strrpos($f_work,",")); } //print $f_work;die; ?>
Volunteer Activities
X ',$a_volunteer[$i]; if($i==5){ print ": ".$_POST["volother"].""; } }else{ echo '    ',$a_volunteer[$i]; } echo ' '; } // remove end comma $f_volunteer = substr($f_volunteer,0,strrpos($f_volunteer,",")); } //print $f_volunteer;die; ?>
Organization/Agency
Advisers: (names of youth)
'; } } } ?>
Registration Fee: $125.00 () *You will not be asked to submit payment at this time.* The fee includes a complete Summit registration packet, a welcome reception, access to all workshops and special sessions, three breakfasts, two luncheons, two dinners, and all refreshment breaks. Registration Fee: The registration fee will be waived for all youth and advisers on scholarship and all speakers and presenters. The fee includes a complete Summit registration packet, a welcome reception, access to all workshops and special sessions, toolkits for workshops you attend, three breakfasts, two luncheons, two dinners, all refreshment breaks, and entertainment at the Summit. Hotel Arrangements: Please note: Scholarship award recipients and speakers will be asked to provide a credit card number when making hotel arrangements. The hotel will use this credit card number to cover the cost of incidental expenses charged to your room. If you are not able to attend the Summit, you must notify NCFY (by e-mail or fax) of your change in plans no later than July 20 at 4:00 pm EST. You must also notify the hotel. Otherwise, the hotel will charge your credit card for a one-night stay. $val){ if($key=="user_type"){ echo ''; }else{ if($key=="attend"){ echo ''; }else{ if($key=="work"){ echo ''; }else{ if($key=="volunteer"){ echo ''; }else{ if($key=="youth_fname"){ if(is_array($_POST["youth_fname"])){ $f_youth_fname = $_POST["youth_fname"]; for($i=1;$i<=8;$i++){ echo ''; } } }else{ if($key=="youth_lname"){ if(is_array($_POST["youth_lname"])){ $f_youth_lname = $_POST["youth_lname"]; for($i=1;$i<=8;$i++){ echo ''; } } }else{ echo ''; } } } } } } } ?>