Youth Frontiers - Building Positive School Communities - Priority 1 Form

Note: For the Courage Callback (assembly, post-Courage Retreat) click here for your Priority One form.

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 students!

*Required Information

School Information

School Name*
School Address*
City*
State*
Zip*
How many schools will participate in the retreat? If more than one, please list the schools attending.

Contact Information

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

First Name*
Last Name*
Title*
Work Phone*
Fax*
Alternate Phone* (cell or home number)
Work E-Mail*
Second Contact Name
Second Contact Title
Second Contact Work Phone
Second Contact E-Mail Address

Courage Retreat Information

Note: The recommended length for a Courage Retreat is 5 hours 15 minutes. For smaller groups ( < 100 students) 5 hours is ideal. For larger groups ( > 150 students) consider scheduling 5 1/2 hours. We also ask that the leaders arrive 45 minutes before the retreat start time.

Retreat Date*
Retreat Start Time*
Retreat End Time* (total length approx 5 hours 15 minutes)
Leader Arrival Time* (45 minutes before retreat start time)
Grade(s) of Students*
Number of Students*
In an effort to share our work with others, would you allow visitors to attend your retreat? (potential donors, principals, teachers, etc.)
Will you allow Youth Frontiers to submit a press release regarding your retreat?
If so, please provide a short testimonial that can be included in the press release. (e.g. "Our school uses Youth Frontiers because...")

Small Group Leader Information

Note: Students will participate in small group discussions throughout the retreat. It is helpful, but not necessary, if the leaders have a way of identifying themselves visually (e.g., red shirts, school colors). We offer YF leader t-shirts at an additional charge if interested (see below).

Number of Small Groups* (approx 7 students per small group)
Number of Leaders* (at least 1 leader per small group)
Name of Leaders' School or Organization*
Grade of Leaders* (student leaders must be at least 2-3 years older than retreat participants)

Check the box if you would like to purchase YF t-shirts for your leaders ($10 each)

Lunch Information

Note: Lunch time must remain flexible. Thank you.

What type of lunch will you provide participants?	Bag Other
If other, what type of lunch?
Will lunch be provided for our staff?*	Yes No
Will you provide a snack for retreat participants?	Yes No
What type of snack? (We recommend self-contained, individually wrapped snacks such as granola bars. No large, plastic water bottles please.)

Retreat Location Information

Retreat Location Name*
Address*
City*
State*
Zip*
Phone*

Retreat Location Comments

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

Additional Information

Are there any school policies we should be aware of the day of retreat? (e.g., cell phones, hats, iPods/earphones)
If yes, please explain.

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 is your school funding this retreat? How could Youth Frontiers be a resource for your school in finding retreat funding?

How did you hear about Youth Frontiers?

Thank you for taking the time to complete the Priority One Form for your Courage Retreat!

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!