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Kansas YAG Registration Form
Please complete this form to participate in the Kansas YMCA Youth and Government Virtual State Conference on March 26-27.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
School
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Zip
*
Your answer
High School Graduation Year
*
Choose
2021
2022
2023
2024
Gender
Choose
Male
Female
Non-Binary
Prefer Not to Answer
Race
Choose
American Indian or Alaska Native
Asian
Black or African American
Hispanic
Native Hawaiian or Other Pacific Islander
White
Two or More Races
Terms of Agreement
I have reviewed the Virtual Code of Conduct and Student Code of Conduct and agree to abide by all the rules and requirements set forth by YMCA Youth and Government.
I agree
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