2022 MOYAG Student Registration Form

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2022 MOYAG Student Registration Form

All students must complete this form by September 21. You must be in a delegation and complete all required fields to register for the program. You also must turn in the Student Safety and Conduct Form to your delegation advisor after it has been signed by you and a parent/guardian.

School/Delegation *

First Name *

Preferred Name *

This is what will be used on your name tag

Last Name *

This will be my _____ year in YAG.

High School Graduation Year *

T-Shirt Size *

Date of Birth *

YYYY

Gender *

Which gender do you identify with?

Male

Female

Non-Binary

Other:

Ethnicity

Are you of Hispanic, Latino, or Spanish origin?

Yes

Prefer not to say

Clear selection

Race

How would you best describe yourself?

American Indian or Alaska Native

Asian

Black or African American

Hispanic

Native Hawaiian or Other Pacific Islander

White

Prefer not to say

Other:

Dietary Restrictions

Do you have any dietary restrictions? YAG will work to accommodate as best as possible.

None

Vegan

Vegetarian

Lactose Intolerance

Kosher

Gluten Free

Nut Allergy

Other:

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