Please fill out the information below to register your sophomore student (as well as an alternate student) for Maine Youth Leadership's four day seminar to be held June 1st to June 4th, 2017 at the University of Southern Maine. The nomination deadline is February 28th, but earlier nominations will give your school a greater chance to have a second student invited at no cost based on our space availability. We will contact each student by mail in March with a packet including health forms and information for parents. There is no cost to students to attend MYL; if you would like to guarantee a second spot for another student from your school, the cost is $250 per student. Please note that cancellations after Sunday, May 28th will incur a $50 cancellation fee to cover prepaid costs. Please contact Jim Cox for more information at 207-221-3196 or info@maineyouthleadership.org.

If you would prefer to mail in your nomination, download the nomination form

Principal's Name *
Principal's Name
School's Phone Number *
School's Phone Number
Your Name *
Your Name
Your Phone Number *
Your Phone Number
Nominee's Name *
Nominee's Name
Nominee's Phone Number *
Nominee's Phone Number
Alternate Student's Name
Alternate Student's Name
Alternate Student's Phone Number
Alternate Student's Phone Number