The ICAS Youth Excellence Program

Institute for Corean-American Studies, Inc.

Leadership Training Conference Washington D C

March 24, 2008 Monday 6:00 AM - 10:30 PM

Let's Learn More about America

Opening Young Minds and Expanding Horizons
Building Capacity, Fostering Opportunity, Investing in the Future
Enhancing Good and Productive Citizenship

Meet, Visit, Greet, Brief

Senior Officials, Heritage Foundation (confirmed)
US Capitol (confirmed)
Senior Officials, US Department of Justice (confirmed) White House (pending security clearance and reconfirmation)

US Library of Congress (confirmed)
Senior Officials, US Mint (confirmed)

(subject to amend, change, and modification)

Delegate qualifications: student (B average and school's permission)

Guide and Faculty: ICAS Staff

On-Line Registration
RSVP by March 7, 2008

Student's/Participant's Name: ________________________________grade__________________
Email _______________________________ Tel ________________________
Date of Birth __________________________________________________________________
Place of Birth _________________________________________________________________
Social Security Number (for security clearance purpose only)______________________________
Father's/Mother's/Guardian's Name _________________________________________________
Mailing address ________________________________________________________________
Tel ______________________ Fax ________________ Email __________________________
Name of school ______________________________________________________
Principal's name ______________________________________________________
Tel: _____________________ Fax: ________________ Email _________________

Confirmed student participants will be invited to an orientation workshop+ which will include a lecture on

+March 16, 2008 2:00 PM - 5:00 PM

How to Build Brain Power?
How to Enhance Academic Performance?
Preparing for College/University/Graduate School/Professional School (i.e., PhD, JD, MBA, MD)
Preparing for Post-College/University Career Development

Qualified student participants may be invited to compete for **ICAS Youth Excellence Fellowship Awards Contest Invitational 2008.

**ICAS Youth Fellowship Award
ICAS Youth Excellence Fellowship Awards Invitational 2005 Winners
Youth Excellence Award Winners

Release of Liability

Date this form executed _______________________________

Applicant's Name ________________________________ DOB _________________________
Age __________________ Grade ___________________ Signature ______________________
Parent/s, Guardian/s Name/ _________________________________________________________
Mailing Address _________________________________________________________________
Name of School you attend _________________________________________________________
Principal's Name _____________________________
Tel ________________________ Fax _________________ Email ______________________
Emergency Contact Person __________________________________________________________
Relationship _________________ Tel __________________ Email _________________________

Any Concerns (i.e., medical, et al) of which we should be aware. (Please use a separate page if needed)


Health Insurance Inforamtion: Policy Name _____________________________________________
Policy Holder _____________________________________________
Policy Number ____________________________________________
How did you hear about the ICAS Youth Excellence Program (ICASYEP)?


Did you participate in the ICASYEP during the past year?

Release of Liability

In consideration of acceptance as a participant in the ICASYEP, I hereby agree for myself, my heirs, my executors, administrators and any minor child (if applicable) to waive and release any and all rights and claims for damages I may have against the ICAS , its employees, other ICAS members, directors, staff, fellows, and their respective families, sponsors, and their representatives, successors, and assigns and will hold them harmless for any and all inuries suffered in connection with any ICASYEP event/s or while traveling to or returning there from. Also, none of the above are responsible for the loss of personal items and any other form of aggression in connection with any ICASYEP activities.

I verify that I am physically fit and that my physical condition has been verified by a licensed medical doctor. I also hereby consent to permit emergency treatment in the event of injury or illness.

Signature of parent(s)/guardin _______________________________

Date _______________________________

NB: A parent/guardian must fill in this form.

ICAS reserves all rights including the right to dismiss any participant and, in that case, no refunds shall be made. Any cancellation requiring a refund must be made in writing with two weeks advance notice. Otherwise, there shall be no refunds. Further details will be provided upon completion of registration.

ICAS Liberty Foundation seeks to promote the cause of humanity, peace, prosperity and security through cultural, educational and research activities.

All rights reserved. February 14, 2008