Forms
 

Contact Information

Address:

Maine YMCA Youth in Government

31 Town Hall Lane  

Winthrop, ME 04364

Director: Lonney Stevens

 

Phone: 207 - 377 - 9686

 

Email:Click Here

 

 

* Required Fields

Register for Maine YIG

* First Name:

 

* Last Name:

 

* Grade:

 

* School / Club / YMCA:

 

* Gender:

Male        Female

* Age:

 

* Email:

 

Training Session:

 

Housing Information:

I will be staying at home

My delegation has Arranged to stay in a hotel

I need to be assigned a Host Family

* Parent's Name:

 

* Home Phone:

 

* Address Line 1:

 

* Address Line 2:

 

* City / Town:

 

* Zip:

 

Insurance Carrier:

 

Insurance Policy #

Allergies:

 

Medications:

 

Medical Conditions:

 

 

Return to Top