Delegate First & Last
1
Jane Delegate
2
Sam Forumkiddo
3
Donna Courtprograms
4
Lana Legislator
5
Illana International
6
Patty Banker
7
Juan Smith
8
Kim Editorio
9
Lawrence Lemon
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Delegate First
Delegate Last
Photo
Attendance Notes
For coalitions, record delegation here
Del Leadership?
Delegate Cell Phone
Delegate Email
Political Party
Program Area
CalY Leadership Role
ForumCmte
Running for Office? (x)
Which Appt/Elected Office?
Interviews/Mtgs?
Family
hotel room #
DOB
Gender
Address
City
Zip Code
HS
Grade
Years in Program
Sweatshirt Size
T-shirt Size
Parent 1 First
Parent 1 Last
Parent1 Home Phone
Parent 1 Cell Phone
Parent 1 Email
Relationship to Delegate
Emergency Contact Name
Relationship to Delegate 2
Emergency Contact Phone
Allergies
Dietary Restrictions/Preferences
Primary Sponsor?
Secondary Sponsor?
Session 1
Session 2
Session 3
Session 4
Deposit
Sept Payment
Y-Assist $
Total Due
Oct Payment
Nov Payment
Dec Payment
CalY Scholarship 1
CalY Scholarship 2
Car Wash Fundraiser
Balance
Notes
Jane
Delegate
North
President
555-1212
jane@email.com
Trout
Forum
Criminal Justice
Red
101
11/1/2002
Female
123 Poplar St
Anytown
09482
Joint Union High School
9
First
S
S
parent@parent1.com
Vegan
CC-Hall 1
DT-Salon AB
$100.00
$200.00
$500.00
$1,200.00
$200.00
$200.00
$200.00
$75.00
$125.00
$100.00
$0.00
Extended payment plan
Sam
Forumkiddo
South
President
554-1234
Avocado
Forum
Environment
Yellow
101
8/7/2004
Female
8978 Maple St
Anytown
09482
Joint Union High School
9
First
S
S
Latex
Vegetarian
CC-Hall 1
DT-Salon AB
$100.00
$400.00
$1,700.00
$400.00
$400.00
$400.00
$0.00
Donna
Courtprograms
South
555-5985
Avocado
Appellate Court
Chief Justice
Sunday 1pm, VH-Coatroom
Yellow
102
6/5/2002
Female
480 Coronado Lane
Anytown
09482
Joint Union High School
11
First
M
L
Tree nuts
Gluten Free
VH-Cotton
CC-2009
$100.00
$400.00
$1,700.00
$400.00
$400.00
$400.00
Sent mom reminder 12/17
Lana
Legislator
Parents will drop off in Sac
West
President
534-1293
Grizzly
Leg Houses
Chief Whip
Saturday 2pm, CC-2001
Red
102
5/10/2001
Female
909 Happy Circle
Anytown
09482
Anytown Comprehensive High School
11
Third
M
L
No Lactose
1024 SB
CC-Hall 2
CC-Hall 3
$100.00
$400.00
$1,700.00
$400.00
$400.00
$400.00
$0.00
Illana
International
West
Secretary
436-3598
Grizzly
IAC
Green
101
1/1/2002
Female
2909 Democracy Row
Anytown
09482
St. Mary's High School
10
Second
M
L
Peanuts
CC-2001
CC-2001
$100.00
$100.00
$300.00
$1,400.00
$100.00
$50.00
$185.00
$25.00
$840.00
Patty
Banker
West
435-4390
Gold
CIB
Yellow
101
2/14/2003
Female
28 Wall Street
Anytown
09482
St. Mary's High School
10
Second
L
L
CC-2009
CC-2005
$100.00
$400.00
$1,700.00
$400.00
$400.00
$400.00
$0.00
Juan
Smith
No T&EI
North
556-1212
Poppy
Bench Trial
Supreme Court
Sunday 11am, VH-Cotton
Red
103
12/5/2001
Male
2889 Wind Ave
Anytown
09482
Joint Union High School
10
Second
XL
XL
Strawberries
Vegan
Gluten Free
VH-Reedly
VH-Reedly
$100.00
$1,600.00
$1,700.00
$0.00
Check #1202, Sept 28 mtg
Kim
Editorio
East
President
698-1989
Gold
Media
Green
103
10/4/2002
Male
20888 Capitol Ave. Apt 3A
Anytown
09482
St. Mary's High School
12
Fourth
S
M
CC-2000
CC-2000
$100.00
$400.00
$1,700.00
$400.00
$400.00
$400.00
$0.00
Lawrence
Lemon
East
VP
398-3985
Gold
SoS
Undersecretary of State
Green
103
12/23/2003
Male
2 Friendship Court
Anytown
09482
Homeschool
12
Third
L
L
VH-Coatroom
VH-Coatroom
$100.00
$150.00
$680.00
$1,020.00
$200.00
$115.00
$115.00
$100.00
$185.00
$55.00
$0.00
9 records

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