2-Page Registration Form



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REGISTRATION FORM

22nd Global Youth Justice Training

Youth/Teen/Student/Peer Court and Peer Jury

“Establish, Enhance and Expand”

Las Vegas, Nevada, USA

June 18-20, 2019

Tuesday to Thursday

3 Easy Steps to Register

Step #1 Read information on Global Youth Justice Website button titled “Upcoming Trainings”.

Step #2 The Two (2) options to register include: (1) Fill out this Registration Form for each participants and e-mail it to Scott.Peterson@ and request a secure PayPal Invoice, so you can use a personal/business/employer Debit or Credit Card – about 90% of registrants us the PayPal Option or (2) Fill out this Registration Form and mail it with a $195 check made payable to Global Youth Justice, Inc. For registering multiple participants, one check can be made out for $195 per person for USA residents and $250 for international registrants. Mail registration form(s) for each participant and registration fee to: Scott Peterson, CEO, 12 South Sparrowbush Road, Latham, New York, 12110. Call 202-468-3790 with any questions.

Step #3 Registration approval is fairly on a 1st registered and 1st paid basis. Registration approval is required before participants can proceed with travel, and before Global Youth Justice provides approved participants with the “Code” to book rooms at the reduced rates in the Global Youth Justice contract with the Tuscany Suites and Casino in Las Vegas, USA.

Name: ___________________________________________

Title: ___________________________________________

Organization: ___________________________________________

Address: ____________________________________________

City/State/Zip: ____________________________________________

Phone Number ____________________________________________

E-mail address #1: ____________________________________________

Optional 2nd E-mail: ___________________________________________

Have you ever worked, been involved with and/or volunteered at a local youth court, teen court, student court, peer court, youth peer panel or youth peer jury program?

Yes ____ No____

If yes, write program name: ________________________________________

Purpose for Attending this Training

Eligible participants include individuals and teams of 2-5 individuals. Eligibility includes adults only interested in Implementing, Enhancing, Expanding and/or Learning more about these rapidly expanding Juvenile Justice and Youth Justice Diversion Programs.

Please indicate your reason(s) for attending this Global Youth Justice Training

Check one (1) or more options below

Implementing ________

Enhancing ________

Expanding ________

Learn ________

Registration, Presenting and Other Information

Global Youth Justice Trainings are subsidized as a result of donations, fundraising, and in-kind charitable contributions, which is why the Registration Fee and Hotel Rooms are inexpensive. Global Youth Justice Training fill to capacity, so if you are interested in attending, it is best to register early, as space is limited for these Global Youth Justice Trainings. The Registration Fee includes (2) breakfasts, (2) lunches, (3) days of training, training materials, ½ day grant writing and resource session and more. Registration is 100% refundable up until the 10-days before the training. Cancellation after this is 50% of the registration fee being reimbursed, as we are required to pay the hotel for Food 10-days before.

Interested in Serving as a Presenter: Yes_____ NO_____

If yes, Global Youth Justice will contact you for more information.

Questions

Please call Global Youth Justice at (202) 468-3790 or e-mail Scott.Peterson@.

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