SCY Youth with Disabilities in Conflict with the Law Roundtable
35th Anniversary Celebration & AGM
Registration

Please fill out the following:
Fields marked with * are required.

I would like to attend as an:
     Organization
     Individual

I am a:
     Youth
     Adult

I would like to attend the:
     Roundtable Only ($50 - includes SCY Annual Membership)
     AGM Only (Free)
     Anniversary Dinner Only ($50 - includes SCY Annual Membership)
     Roundtable & Anniversary Dinner ($75 - includes SCY Annual Membership)
Name *
Organization
Address *
City *   State/Prov. *
Country *   Zip/Post. Code *
Phone *
E-mail *
Comments

Thank you for completing the registration. We look forward to your attendance.