2018 Youth Leadership Summit Offline Registration Form August 1st – 5th, 2018 - Aurora, CO

For more information or to register online with a credit card, please visit: http://sistercities.org/yls

Registration Information—PLEASE PRINT CLEARLY If you are registering multiple students, please complete the first page for each person.

First Name ________ Last Name ___________________ Address __________________________ City ___________________ State/Province _____________ Zip Code ____ Country __________________________ Student Cell Phone Number ____ Student E-mail ___________________ Please check this box to opt-out of having your contact information shared with other registrants High School ___ ____ DOB: _______________ Gender: Male Female Sister Cities organization name (if applicable) ____________________________________________________

First Sister Cities International Youth Leadership Summit? Yes No Please list any allergies: ____________________________________________________________________ Please list any medicine(s) the student will be taking on-site: ______________________________________________ Please list any mobility issues: ________________________________________________________________________ Special Dietary Restrictions: [ ] Vegetarian [ ] Gluten-Free [ ] Vegan [ ] Other _______________________________

Check this box if you have read and understand Sister Cities International’s Registration Policies and Procedures

Emergency Contact Information

Name ___________________________________ Day Phone Number ______________________________ Relationship ______________________________ Cell Phone Number ______________________________

Registration Fees Registration will not be processed unless accompanied by full payment. YLS Registration will close Monday, July 2, 2018 at 12:00 noon EDT.

Youth Leadership Summit includes: Dinner on Wednesday evening, Breakfast/Lunch/Dinner on Thursday, Friday and Saturday, Breakfast on Sunday Morning, ticket to the Friday City Welcome Reception, and ticket to the Lou Wozar Annual Awards Dinner. Please note, all students flying to the summit will be required to provide flight information to SCI at a later date.

Please Select One: Type of Registration Member Non-Member

YOUTH LEADERSHIP SUMMIT RATE W/ LODGING For individuals ages 14-18. Accommodations will be at University of Denver dorms for (4) nights – Wednesday, Thursday, Friday, Saturday.

$600

$650

YOUTH LEADERSHIP SUMMIT LOCAL RATE For individuals ages 14-18 that are local to the Aurora area and/or will not need accommodations.

$350

$350

GROUND TRANSPORTATION Ground transportation to/from Denver International Airport on Wednesday, 8/1 between noon-5 pm and Sunday, 8/5 8 AM- noon. If arriving/departing outside of these times, student will be responsible for his/her own transportation.

$25

$25

Payment Information

Total Amount Due $ ________________ ** Include combined total amount of each registrant. All fees must be in U.S. dollars. ** For wire transfers, there is an additional $25.00 internal processing fee. Please check this box if you have added this to your total

Will you be paying the registration by check or wire transfer?

Check Wire Transfer Organization and/or person’s name who is making payment: _________________________________________________________________ Payment Method by Check: (Make checks payable to Sister Cities International. Please mail this form with your check.) Date of Check _________________ Check #__ ________________ Issuing Bank __________________ Payment Method by Wire Transfer: (Please email this form to conference@sistercities.org after the wire has been sent) Date of Transfer __ ________________ Bank & Branch __ ______________________________________________ Address of Bank__ ______________________________________________ City/State/Country __ ______________________________________________ Account # __ ________________________ Routing/SWIFT Code _________________________

Foreign Incoming Wire Instructions (Originator Sending in USD)

Intermediary Bank (Swift Line 56): Wells Fargo Bank San Francisco

Intermediary SWIFT Code: WFBIUS6S

Beneficiary Bank (Swift Line 57): EagleBank Bethesda MD 20815

Beneficiary Bank ABA (Include / / FW): / / FW055003298

Beneficiary Name (Swift Line 59): SISTER CITIES INTERNATIONAL

Beneficiary Account: 0200156875

For Further Credit (Swift Line 72): Any reference: PO, Invoice No., or Purpose of Payment

Once payment and a completed form is received, SCI will register the student(s) and provide a confirmation via email.