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"If everyone in the world could experience a Courage Retreat, the world would be very different."
7th Grader, Courage Retreat

Student Priority One Form

Priority One Form

Attention Youth Frontiers Clients

Required fields are marked with *, please fill out all these fields before submitting. If you still experience problems, print out your completed Student Priority One Form and fax it to Youth Frontiers at 952.922.2122. If you have any questions, please call Emily at 1.888.992.0222. Thank you.

School Information

*Required Information

School Name*

School Address*

City*

State*

Zip*

Contact Information

First Name*

Last Name*

Title*

Work Phone*

Home Phone*

Fax*

Work E-Mail*

Second Contact Name

Second Contact Title

Second Contact Work Phone

Second Contact E-mail Address

Check the box if both contacts will attend the retreat.

Would you accept visitors on your retreat? (i.e. potential donors, principals, teachers, etc)*

Retreat Information

Retreat Date*

Retreat Type*

Retreat Start Time*

Retreat End Time*

How many schools will participate in the retreat?
If more than one, please list the schools attending.

Grades of Students

Number of Students

Retreat Location Information

Retreat Location Name*

Address*

City*

State*

Zip*

Phone*

Detailed Directions to Location

Leader Information (Kindness, Courage, Respect retreats only)

Number of Leaders

Name of Leaders' School

Number of Small Groups

Grade of Leaders (We recommend that student leaders be at least two grades older than participants.)

Leader Arrival Time* (Please allow a half-hour before retreat starts.)

Check the box if you would like to purchase t-shirts for your leaders ($10 each)?

Lunch Information

Will lunch be provided for our staff?*

Yes No

What type of lunch will you provide participants?

Bag Other

If other, what type of lunch?

Will you provide a snack for retreat participants?

Yes No

What type of snack?

Note: Lunch time must remain flexible. Thank you.

Kindness Assembly

Assembly 1

Times

Grades

Number of Students

Assembly 2

Times

Grades

Number of Students

Assembly 3

Times

Grades

Number of Students

Additional comments (if any)

Leadership Retreat

Are the students part of an established leadership group?

If "Yes", what?

Yes No

Are the students self electing to attend the retreat?

If "No" how are they selected?

Yes No

Please list the names of the schools attending the retreat

Additional Information

What is the name of your community newspaper?

Is there any additional information Youth Frontiers should know to best serve you?

Are there any dress code policies (or dress code recommendations) you would like us to be aware of?
If yes, please explain.

We've heard from many schools that it's increasingly difficult to find financial resources to fund retreats. How is your school funding this retreat? How could Youth Frontiers be a resource for your school in finding retreat funding?

How did you hear about Youth Frontiers?

Thank you for taking the time to complete your Student Priority One Form.

If you have any questions, please contact Emily at 1.888.992.0222.

Submit your form by clicking the button below. Thank you!