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<br /> <br />4TH ANNUAL TEXAS YOUTH ADVISORY COM~JnSSION SUMMIT <br />MARCH 6 -7, 2004 · MESQUITE, TEXAS <br /> <br />Registration: <br /> <br />Registration fee is $10 per youth attending the summit. with a limit of 300 students. There is not a fee for adult <br />sponsors/chaperones, but we do ask that sponsors/chaperones register. <br />The registration fee includes a T-shirt, Saturday breakfast and lunch, Saturday evening dinner and dance, and <br />Sunday breakfast. <br />Please complete one form per individual attending. Make checks payable to City of Mesquite - Youth Services <br />and mail along with your payment to: <br /> <br />r----------~---------_________~________________~ <br /> <br />CITY OF MESQUITE YOUTH SERVICES, Attn: Youth Summit <br />P.O. Box 850137, Mesquite, TX 75185-0137 <br /> <br />Once your registration foon and fee are received they will be processed on afir.st-cDme-first-served basis. <br /> <br />Full Name: <br /> <br />Badge Name: <br />City/Organization: <br /> <br />Title: <br />Address: <br /> <br />City: <br />Phone: <br />E-mail: <br /> <br />State: <br /> <br />Zip: <br /> <br />Fax: <br /> <br />Will your city need a display table? 0 Yes 0 No <br /> <br />Check one: 0 Youth 0 Adult <br />T-shirt size: 0 Small 0 Medium 0 Large 0 Ex Large <br /> <br />o 1X 02X <br /> <br />----------------------------------------------~ <br /> <br />Registration Deadline February 20,2004. <br />