Student

Name: *

Grade Entering in Fall: *

School: *  Middle High

Parent's Name:

Phone: *

Emergency phone: *

Do you need an interpreter?:      If so, what language?

Do you have any food allergies?:      If so, please describe

Please indicate your desired T-shirt size:  Small Medium Large X-Large

Payment Options You can pay $10 by using (Registration forms are required with payment): Check Make check payable to: Asian American Community Services Mail to: Asian American Community Services Attn: Justin Shum 4700 Reed Rd. Suite B Columbus, OH 43220 Cash Bring it to AACS @ 4700 Reed Rd. Suite B, Columbus, OH 43220

**Financial Scholarships are available upon request. Please contact Justin Shum at 614-220-4023 ext. 222 or jshum@aacsohio.org if you are in need of a scholarship. ****For large group activities, participants will be assigned to tables. If you would like to be placed at a table with a particular person, you must send your registration forms in together. We will do our best to honor your request. Please also list the person’s name here:

** You will need to print out and have a parent/guardian sign release forms to be mailed in with your conference fee. The release forms are all in one word document below that you can click on to access.

Now that you're almost done, click "Register" to finish!