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U.S. Army Installation Management Agency

PACIFIC YOUTH LEADERSHIP FORUM 2008

June 20-26

2008

Winners' Camp

Oahu, Hawaii

The United States Army

Adult Registration Form

 

Procedure:

 

    1.    Print out and complete the Adult Responsibilities form and submit to IMCOM Pacific via your chain of command by the deadline.

    2.    Complete the below registration form and submit.

Note: Online registration will NOT work on Youth Technology Lab computers with active Cybersitter filtering   

First name:
Middle Initial:
Last name:
Name you prefer to be called:
Position Title
Grade/Series
Email Address:
Gender: male female
Collared Out-brief Shirt Size:

Size

 XS S M L XL 2XL 3XL 4XL
Chest  30-32 34-36 38-40 42-44 46-48 50-52 54-56 57-59
 
   
T-shirt Size:

Size

 XS S M L XL 2XL 3XL 4XL
   
Official Military Address
(continued)
(continued)
City:
State:
Zip Code:
Supervisors Name:
   Supervisor' s DSN Phone
   Supervisor's Commerical Phone
   Supervisor's Fax
Installation:
Specify any special needs or medical considerations:
Specify any special physical accommodations needed for housing or training
Individual that can be contacted in case of an emergency (first) - not used elsewhere on this application.
    Relationship:
    Primary Phone:
    Work Phone:
    Cell Phone/Pager
Individual that can be contacted in case of an emergency (second) - not used elsewhere on this application.
    Relationship:
    Primary Phone:
    Work Phone:
    Cell Phone/Pager:

       

email webmaster: registration@paroylf.org