Registration Form:

Name : ________________________________________________________

Mailing Address: __________________________________________

_______________________________________________________________

Phone number: _________________ Fax number: ______________________

Email address: ___________________________________________________

Is your group faith based, educational, or recreational in nature?( Circle one) Yes No

Specific Name of Youth Group: _________________

Number of years that you have been in! volved in youth groups: __________

Have you ever written and received grant funding (work, church, etc.) _______

How would you assess your writing skills? (circle one) Excellent Good Fair Poor

Have you ever written a budget? (circle one) Excellent Good Fair Poor

What is the purpose of the youth group that you are a part of?
_______________________________________________________________________

How many youth participate? _______________

How many adult advisers, teachers, and parents are involved? _____________

What type of activities does the group engage youth in? ______________



What is the age group?
(circle one) Ages 1- 6 Ages 7-10 Ages 12-14 Ages 15+


Is there a leader group or officers among the youth? __________

How is the group funded? (please be list- grants, donations, dues, membership fees, etc.)
_____________________________________________________________________________________

What was your budget last year (2005)? _______________________________________

What are three objectives of the group for this year?

________________________________________________________________
________________________________________________________________
________________________________________________________________

Please identify 1-2 grants! that your team will write for and bring the specific criteria.



Please send all materials by 1/10/06