...advocating for evidence based policies and practices to prevent and reduce alcohol-related harms

Youth Leadership Workshop Application

The Youth Leadership Workshop is an opportunity to learn new skills, identify ways to effectively prevent underage drinking and meet other students committed to making a differerence in their communities.

The registration deadline is Monday, June 7, 2021

Space is limited, so apply early!

Questions? Call Project Extra Mile at (402) 963-9047 or e-mail us at youth@projectextramile.org

First Name*

Last Name*

Address 1*

Address 2

City*

State*

Zip*

Student E-mail Address*

Student Cell Phone Number*

T-Shirt Size*

Parent/Guardian Name(s)*

Best Number to Contact Parent/Guardian*

Parent/Guardian E-mail Address*

School You Will Be Attending*

Grade in School for 2021-2022 School Year*

Allergies/Dietary Restrictions