YUGA Group Registration Form

Please fill in the information below regarding your YUGA group.                      * required field

Is this a School Group?* 

Yes      No

If this is a school group: 

 

School Name:  

School Address:  

School City:  

School State:  

School Zip Code:  

School Phone:  

Group Information: 

 

Group Name:* 

Group meets: 

Goals of the group: 

(i.e. show a film on World AIDS Day to
raise awareness about this issue):

Group Leader Name:* 

Group Leader Email:* 

Group Leader Phone:* 

Group Leader 2 Name: 

Group Leader 2 Email: 

Group Leader 2 Phone: 

Group Adult Facilitator Name: 

Group Adult Facilitator Email: 

Group Adult Facilitator Phone: 

Facilitator Relationship: 

Member Information: 

 

Member Names

Member Emails

Member Phones

After completing this form please click the submit button.
You can also print this page and mail it to:
YUGA | Plan USA | 155 Plan Way | Warwick, RI 02886