Student Life

Governance Summit Registration Form
Application Deadline is October 16, 2009
Name: (*)
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Phone: (*)
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Address: (*)
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City/State/Zip (*)
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E-mail: (*)
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High School: (*)
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Student Council Advisor: (*)
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Advisor's Email: (*)
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Class: (*)
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T-shirt Size: (*)
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High School Invovlvement:
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Community Service:
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Honors:
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Would you like more information about NKLI? (*)
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Please note: There is ten dollar ($10) fee to attend this conference. This fee will provide lunch, a conference t-shirt, and all conference materials. Please make checks payable to NKLI and submit to the following address:

Office Of Student Life SU 306
Highland Heights, KY, 41076

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Note: (*) indicates field is required.