Junior Youth Assembly Delegation Reservation Form
March 6-8, 2022
Hotel Address: 1325 Virginia Ave, Atlanta, GA 30344
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Email *
School Name (full name, please) *
Advisor Name *
Advisor Email *
Advisor Cell *
How many student registration slots would you like to reserve? *
How many advisor (double occupancy - $200) registrations do you expect?
How many advisor (single/private occupancy - $400) registrations do you expect?
Of your students, how many do you expect will participate in the legislative program?
Of your students, how many do you expect will participate in the media program?
I affirm that I realize that I am reserving spots for Youth Assembly program.  In order to secure my reserved spots, I will complete a full registration by February 1 and will submit payment by February 16.  Payments not received by this deadline will result in forfeiture of the reserved spots.  We do not allow refunds, but gladly allow for student substitutions.
Comments and/or questions
A copy of your responses will be emailed to the address you provided.
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