More Than Smart Priority 1 Banner

Required fields are marked with *, please fill out all these fields before submitting. If you still experience problems, print out your completed Priority One Form and fax it to Youth Frontiers at 952.922.2122. If you have any questions, please call the Retreat Coordinator at 1.888.992.0222. Thank you--we are looking forward to working with your community!

*Required Information

School Information

School Name or Organization*

School Address*

City*

State*

Zip*

Contact Information

Note: The contact information entered should be for the person you would like Youth Frontiers to contact for program logistics (i.e., the person at your school/organization who will be handling the details).

First Name*

Last Name*

Title*

Work Phone*

Fax*

Alternate Phone* (cell or home number)

Work E-Mail Address*

Second Contact Name

Second Contact Title

Second Contact Work Phone

Second Contact E-Mail Address

Event Information

Note: The More Than Smart keynote is 90 minutes in length. We recommend that the audience have at least 50 partipicants in attendance.

Event Date*

Audience Arrival Time*

Keynote Start Time*

Keynote End Time* (length of keynote presentation is 90 minutes)

Estimated Audience Attendance*

Who will be introducing our speaker? (speaker's bio will be provided)

Will you provide one 8-foot, rectangular table (to be used for takeaway materials)?

Will you provide a screen and LCD projector for the keynote presentation?

Event Location Information

Note: We strongly encourage you to hold the program in an auditorium or similar setting (i.e., fixed seating or chairs set up auditorium-style). Gymnasiums are not recommended because of poor sound quality. Please arrange to have the facility opened at least 1 hour before the audience arrives to allow the YF staff to set up.

Event Location Name*

Address*

City*

State*

Zip*

Phone*

What type of room is this?* (e.g., auditorium, library, etc.)

Location Comments

(Optional) Enter anything our staff should know about the location (best door to enter, detailed directions to, parking information, etc.)

Additional Information

Is there any additional information Youth Frontiers should know to best serve you?

What is the name of your community newspaper?

We appreciate your commitment to fund this program, and we'd like to use your wisdom to help other schools as well. How are you funding this program? How could Youth Frontiers be a resource for you in finding program funding?

How did you hear about Youth Frontiers?

Thank you for taking the time to complete the Priority One Form for your More Than Smart presentation!

If you have any questions, please contact the Retreat Coordinator at 952.922.0433 or toll free 1.888.992.0222.

Submit your form by clicking the button below. Thank you!