High School Personnel Registration

Please take a moment to fill out this application and then click the submit button. If you would like a hard copy of the application, please contact our office and we will send you one.

Please select which seminar you would like to attend:

Oakley
NW Kansas Educational Service Center
September 17
Early Registration Deadline: Sept 2


 

 
Liberal
Seward County Community College
October 1
Early Registration Deadline: Sept 16

     
Iola
Allen County Community College
October 16
Early Registration Deadline: Oct 1

      
Hays
Sternberg Museum
October 22
Early Registration Deadline: Oct 7

      
Lawrence
University of Kansas
January 21, 2009
Early Registration Deadline: Jan 9

      
Hutchinson
Hutchinson Community College
January 28, 2009
Early Registration Deadline: Jan 13 		     

 

Advisor or Contact Person(s):
Email
School Name
USD #
Address
City
State
Zip Code
Phone Number
Area Newspaper
Name
Grade
Organization
Special Needs
1
2
3
4
5
6
7
8
9
*10
**11

**For every 10 participants, the 11th is free.

Please register the advisor(s) or chaperone(s) that will be attending:
Cost for each advisor is $15.00

 
Name
Organization
Special Needs
1
2
3
4
5
 
T-Shirt Sizes:
T-shirts will be given to your students at the seminar. Please give us a total number of the sizes that you will need available to you that day. T-shirts are adult sizes.
SM
MED
LG
XL
XXL

How did you hear about KYLA?

 

Payment Options: Please select your method of payment from the list below.
(Please send $25/student and $15/Advisor, if applicable)

Direct Bill: Direct Bill District Direct Bill School

Check: Make checks payable to Kansas Youth Leadership Academy
........Please mail check to: KYLA, 600 Park St. Hays, KS 67601

Credit Card: (Please contact us by phone if paying with a credit card.)


Transportation:
Which vehicle will you use to bring your students (for parking/traffic reasons)
School Bus School Suburban/Van School Car/Personal Car

 


___________________________________________________________________

POLICIES AND PROCEDURES

SEMINAR PAYMENTS

All payments for the Academy Seminars are within 30 days after the seminar, in which you participated. A service charge of 1.5% per month will be applied to all past due accounts.

WEATHER

The Academy has scheduled back-up-dates for each of the seminars that are held during a period in which bad weather occurs. If bad weather should arise on the day of the seminar conducted, we will have cancellations and announcements posted on our voice mail: 785.628.5399, the front page of our website: www.developingleaders.org, and a phone call and e-mail will be sent to the individual(s) who registered for the seminar.

CANCELLATIONS

All cancellations must be received in writing no later than the deadline date for the seminar that you and/or your students are attending. Cancellations will not be accepted after that date and NO refund will be given.

SPECIAL NEEDS:

It is the responsibility of parents/guardians or sponsors to bring any special physical, medical, or behavioral needs to the attention of the director on the application form of the programs the child is participating in. This information will assist us in providing a positive experience for your child.
____________________________________________________________________

You will receive a confirmation packet within 10 days of submitting information. Please contact the office if you have not heard from us within that time frame.



For any questions concerning this form or KYLA please contact:
KYLA
600 Park Street
Hays, KS 67601
(785) 628 5399
KYLA@fhsu.edu

Thanks for Registering!
 
l




"Fortunately for the world, young people are not
easily discouraged."
-Dwight D. Eisenhower

 
Kansas Youth Leadership Academy, Center for Civic Leadership, 600 Park Street, Hays, KS 67601 • Tel 785-628-5399 • Fax 785-628-4051• Email kyla@fhsu.edu
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