Young Men of Color Conference

  Attendance is limited to youth of color ages 12-21. If registering a group from an organization or agency, enter yourself as the Primary registrant and up to 10 youth participants. Please contact lwhite@thehome.org with any questions. Note: the facility is handicap accessible.

*

*

*

 


*  


 

FOR GROUPS: Please enter the first name and last initial ONLY of each youth participant, (eg., John D.):

*

 

(Maximum response 255 chars, approx. 5 rows of text)

 
Question - Not Required - Select One:


   


   


   


   


   


   


   


   


   


   


 
Question - Not Required - Workshop Rankings: Select ONE workshop that you are most interested in attending ( first choice)








 
Question - Not Required - Select ONE workshop that would be your SECOND choice (different from first choice)








 
Question - Not Required - Select ONE workshop that would be your THIRD choice (different from first and second choice)








   Please leave this field empty