Washington State Partnership for Youth
Summit Registration

Three easy ways to register:

Print, fill out and mail form to:

    Washington State Partnership for Youth
    c/o Catherine Suter
    Department of Health
    PO Box 47880
    Olympia WA 98504-7880

Print, fill out and fax form to:

    Catherine Suter
    360-586-7868

Fill out and submit form online: (All fields required)

Register for one of the following dates:
   June 19, 2006 - Yakima, Washington
   June 30, 2006 - Spanaway, Washington

Registration Information:
Name:
Primary Position:
Agency/Organization:
Work Address:
City:
County: State: Washington
Zip:
Day Phone:
Email:

SPACE IS LIMITED. Registration is first come, first served. On-line, fax, and mail registration will close June 19 for Yakima and June 29 for Spanaway. For late registration, check on available space by calling Catherine Suter at (360) 236-3509.

QUESTIONS: Yakima - Gloria Hilsinger, 509-454-3129, gloriah@esd104.wednet.edu
Spanaway - Debbie Lewis, 253-597-7494, Debvlewis@gmail.com