November 2016

Dear Leader,

Thank you for your interest in the Youth Leadership Summit. Youth voice and action are powerful! This is an exciting opportunity for students to network with peers from school districts around the Capital Region and to become leaders in their schools. The Summit will be limited to the first 20 districts to respond with a completed registration packet. Attached you will find the materials needed to complete the registration process.

The cost is $375 for an entire team ($37 per person for each extra team member).

Please return the registration packet and the payment made out to The Academy for Character Education, Sage Colleges, 65 First Street, Troy, NY 12180, no later than NOVEMBER 25, 2016.

Questions?

Call The Academy for Character Education at 518-244-2336 or email Micala Hammond

Media Release Form

I hereby authorize The Academy of Character Education to use my picture, likeness or recordings of my voice. I understand that this video or audio footage may be used for documentary purposes for the Academy and/or promotional videos used by the Academy to help promote the interest of Character Education. I agree that I am to receive no further compensation other than already paid- if any- for any further uses by The Academy for Character Education.

15th Annual Character Education Youth Leadership Summit

December 8, 2016 at Sage Colleges in Troy, NY

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(student signature) (print full name)

Address: ______

______

______

Parent or Legal Guardian, if not 18 years old:

______

(signature)

______

(print full name)

Character Education

2016 Youth Leadership Summit

Commitment Form

Success depends upon the full participation of each member of the school team. By signing your name below, you agree to the following terms:

  • Meeting with your team at least one time before December 8, 2016 to learn about what your school is already doing to foster Character Education
  • Completing and returning media release form with the registration materials
  • Meeting with your team on a regular basis after attending the conference
  • Being actively involved with carrying out your team’s action plan
  • Completing a follow up survey in the Spring of 2017

Signed ______

Date ______

2016 YOUTH LEADERSHIP SUMMIT

Team Inventory

Please print (clearly) your answers to the following questions: (add additional pages if need be)

Why do you want to be involved in this Character Education conference? ______

What is your school currently doing about Character Education?

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What would you identify as the most significant Character Education issues or problems in your school and/or community?

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Identify any Service Learning projects going on in your school.

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Character Education Youth Leadership Summit Registration

School District ______

School Name: ______

Team Members:

1. Student______Grade______

2. Student______Grade______

3. Student______Grade______

4. Student______Grade______

5. Student______Grade______

6. Student______Grade______

7. Student______Grade______

8. Student______Grade______

9. Member______Grade______

10. Member______Grade______

ADDITIONAL MEMBERS: Please list them below or you may use another registration form

Contact Information:

School Advisor______

School Phone ______Advisor Phone ______

E-mail______

School name and address ______

______

______

Parent Advisor______

Phone ______E-mail______

School name and address ______

______

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Registration Payment:
School Name:______

AFTER OCTOBER 20th

Regular: 375 +______x 37 = ______
additional number of members total amount

ALL forms and the payment made out to:

The Academy for Character Education
Sage Colleges
65 First Street,
Troy, NY 12180