Email Address  *

Phone Number  *

Host Council  *

Location where the course will be held.  *

What is your position on this course?  *  Course Director   Staff Adviser   Assistant Course Director   Senior Patrol Leader   Conference Staff 

Are you a first-time course director?  *  Yes   No 

How many NYLT staffs have you served on?  *

Have you attended the NYLT Conference before? If so, in what capacity?  *  Have not attended   Assistant Course Director   Staff Adviser   Senior Patrol Leader   Council Youth Representative   Conference Staff 

Have you participated in the Trainer Development Conference or Trainer's EDGE?  *  No   Trainer Development Conference   Trainer's EDGE 

How many youth did you send to the last Leadership Academy?

How many youth do you plan to send to the next Leadership Academy?

What are your expectations concerning this conference?

What specific questions, issues, or concerns do you have, relative to NYLT, that you would like to see answered at this conference?

Do you have any special medical or dietary considerations that we should be aware of?