Registration Form

Please complete this form to register for the Vietnamese American Youth Leadership Conference 2008.

Registration Deadline - June 6, 2008

SPACE IS LIMITED - Register Now

Registration Fee (Registration is not complete until we have received your Conference fee):

  • Conference and Meals - $150 (non-refundable)
  • Pay by credit card

Name Badges and Conference Packets
All name badges should be picked up at the conference in the registration area. Tote bags, conference programs, and conference materials will be distributed at the conference as well.

Official Language
All conference presentations will be in English unless otherwise noted. We regret that we are unable to offer on-site translation services at this time.
 

Send checks to:
National Congress of Vietnamese Americans
c/o VAYLC
6433 Northanna Drive
Springfield, VA 22150

NOTE:  Part of VAYLC will be held at Washington locations that have security protocols. Thus, we are requesting your Date of Birth and Social Security Number. This information will be shared with Federal Government Agencies only, i.e. White House and Pentagon. It will not be shared with anyone else.

Please provide the following contact information (items in red are required):

Title
First Name
Last Name
Middle Initial
Job Title
School/Organization/Company
Street Address
 
City
State/Province
Postal Code
Country
Phone
E-mail
URL
Age
Gender
Date of Birth
Social Security No.
Registration Type
How did you hear about this Conference?
Interested in exhibit space?
Are you currently involved in community service? If yes, please list them.
What are three (3) issues of concern in your community?
How would you like to change your community?
What do you hope to get out of this Conference?
Notes / Comments