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HOME > EVENTS > 2012 Hispanic Heritage Month Events-Latino Youth Town Hall Registration Form

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2012 Latino Youth Town Hall Banner with America Ferrera

2012 Latino Youth Town Hall Attendee Registration

CHCI is excited to have you join the 2012 Latino Youth Town Hall entitled Empowering Latino Youth--Educate. Vote. Lead.

Please complete the following information and we will process your free registration for this event.  

On Wednesday, September 12, proceed to the Ronald Reagan Building Amphitheater Box Office to check-in for this dynamic session.

Should you have any questions or concerns, please email CHCIConference@chci.org.



First Name * 
Last Name * 
Email * 
Field of Study (if in college) 
Company/Organization (if employed) 
Title (if employed) 
Age * 
 Under 18
 18 to 25
 26 to 30
 31 to 35
 36 to 45
 46 to 55
 56 to 65
 Over 65
Highest Level of Education Completed. * 
 I am currently in High School
 High School Graduate
 I am currently in College
 Associate's Degree or Professional Certification
 College Degree
 Graduate Degree
 Doctorate Degree
Are you currently a registered voter? * 
 Yes   No
By registering for this event, I agree to be photographed or videotaped for possible use in CHCI publications and other printed or online marketing materials. Enter "YES" (case-sensitive) to agree.  * 
Pursuant to the Americans with Disabilities Act, please let us know if you require any specific aids or services at this event. 
* Required


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