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Become a Liaison

 
 

 

 

Group Registration

Complete this form to become a 2019 La Raza Youth Leadership/Servicios de la Raza Conference liaison.  As a liaison, you will be allowed to register a group of students for the La Raza Youth Leadership/Servicios de la Raza Conference.  If you are already a liaison, click here to sign in.

Important:  Use this form if you want to register a group of students.  If you only want to register yourself, click here.

 
 
Required Information:
 School:
 
Principal:
 Address:
 
 

City: 

State:

Zip code:


 Contact/Liaison Person:
 
  First Name:
Last Name:
  Telephone:
 
     
  email address:
  Retype email address:
  Password:

 
Retype password:

 


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Servicios de La Raza/LRLYC
3131 W. 14th Avenue
Denver, CO 80211

Copyright 2006
La Raza Youth Leadership
Institute
Phone: (303) 458-5851
StephenD@serviciosdelaraza.org