YoungPFDJ (YPFDJ)

North America 10th Eritrean Youth Conference August 28 - September 1, 2014
Personal & Demographic Information

First Name *
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Eritrean ID#
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City *
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Postal Code *
Zip Code is required.
Email *
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Date of Birth * / /
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Level of Education
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Tshirt Size *
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Note: You must be at least 16 years of age to register online. If you are under the age of 16, please contact your local YPFDJ chapter or email HIDRINorthAmerica@gmail.com

Last Name *
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Street Address *
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State *
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Primary Phone *
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Gender *
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Place of Birth *
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Mother Tongue
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Emergency Contact Name *
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Relationship to participants *
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Past Conference Attended
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Arrival By *
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Arrival Point
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Departure Time
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Registration Fee *
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Emergency Contact Phone Number *
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Are you a member? *
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Arrival Date * / /
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Arrival Time
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Departure Point
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Indicate Any Special Need
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