Page 39 - Mississippi_Municipalities_V66N4

REGISTRATION
Statewide
11th Annual
YOUTH
LEADERSHIP SUMMIT
MARCH 2-3, 2018 • JACKSON STATE UNIVERSITY • JACKSON, MS
REGISTRATION FEE IS $25
FOR CITY OFFICIALS, ADULTS & YOUTH.*
Registration fee includes:
Friday night Welcome Reception, Summit T-shirt, Saturday breakfast and lunch.
No Refunds after February 2, 2018.
(Please print legibly)
Full Name _________________________________________________
Badge Name _______________________________________________
Title _____________________________________________________
City/Organization ____________________________________________
Address __________________________________________________
City _____________________________State ______ Zip ___________
Phone ____________________________________________________
Fax ______________________________________________________
E-mail ____________________________________________________
TOMORROW’S LEADERS TODAY
Will your Mayor’s Youth Council need a display table? Yes ________ No ________
Will your city attend the Welcome Reception on Friday night?
Yes ________ No ________
T-SHIRT SIZE (Please select one)
____Small ____Medium ____Large ____X-Large ____2X ____3X ____4X
• Pleasecompleteoneformperindividualattending.
• Youmayfaxto601-353-6980.
• MakecheckspayabletotheMississippiMunicipal League and mail along with your registration form to:
Mississippi Municipal League
Attn: Statewide Youth Leadership Summit 600 East Amite Street, Suite 104
Jackson, MS 39201
Registration Deadline is February 2, 2018
*Students must be 9th-12th grade only.
If your group is interested in touring the JSU campus, please contact the MML office at 601-353-5854
Volume 66 • Number 4
Mississippi Municipalities • 39