Theme: Fullticipate to Elevate: Enhancing Development through Youth Participation.

November 24-26, 2010

Knutsford Court Hotel
Kingston, Jamaica

Participant Application Form

Instructions: Please respond to all fields. Incomplete applications will not be considered/
Please be as clear and concise as possible. If a question does not apply to you, simply enter
N/A (not applicable).

First Name:
Last Name(s):
Date of Birth (MM/DD/YYYY):
Country of Birth:
Home Address:

Country of residence:
Nationality:

Contact telephone: Home: Cell:

Gender: Female ( ) Male ( )

Personal Email address(s):

Please choose the response (s) that best represents you: I am a/an

( ) Student Attending ( ) High School ( ) Tertiary Institution

( ) Advocate
( ) Young Professional
( ) Unemployed
( ) Volunteer
( ) Student Representative/Leader
( ) Peer educator
( ) Other, please specify _____________________

Name of Organization/ Group/ Club or Institution:

Address or location:

Website (if any):

Telephone #:
Email address:
What is your role in your organization:

Target population(s) you work with:

Description of the work you have done: (max 200 words)

Do you belong to any networks? Yes ( ) No ( )

Which one(s)?
Have you ever participated in a:

( )Youth workshop
( ) Conference
( ) Advocacy Training session
( ) Youth expo

If so where and when? (Additional details can be provided where necessary)

Which of the topics below are of interest to you?

( ) Youth Advocacy – Old problems, new approaches, Youth advocacy through the media and
Creative arts; Youth advocacy in the inner city; Advocating for vulnerable youth
( ) Creating a Healthy Generation of Youth – Sexual reproductive health and rights; Youth
Identity; Positive Values/attitudes; Self-esteem; Youth empowerment
( ) Youth in Governance - Advocacy; Youth leadership; Decision-making; Policy-making; Youth
Rights; youth representation; Impact of youth leadership in the region

Others, not listed_____________________________________________________________

How will you use the information and resources received from the Conference?
(max 100 words)
Did you participate in the last Yute X Conference held in 2008?

Why would you like to participate in this year’s Yute X Conference? (max 100 words)

Please indicate on which day you would like to attend the Conference:
NB: Participants may attend all three days, but will be responsible for their own transportation/accommodation.

( ) Day 1 November 24, 2010

Themes: Youth Rights & Participation, Who am I: Values & Identity, Creating a healthy generation of youth (Crime & Violence,
Communication across generations) plus Career talks and abstract driven sessions.

( ) Day 2 November 25, 2010

Themes: Youth in Governance, Youth Leadership in Jamaica and the region, Employment & Education, Creative Industries,
Entrepreneurship, Technology, The cost of not Investing in our youth.

( ) Day 3 November 26, 2010

Themes: Climate Change & Environmental Sustainability, A Glance at Vision 20:30, The Charter of Rights: What it means for YOUth,
Youth & Sports, Networking & Building Partnerships, Youth Empowerment.

Features: Conference closing

Did you submit an abstract/proposal for presentation at the Conference? If so, what
was your area of focus?

Do you have any special dietary requirements? Yes ( ) No ( )

If so, what are they ___________________________________________

Do you suffer from any allergies? Yes ( ) No ( )

Which? ____________________________________________
For International participants, how will you fund your participation at the Yute X
Conference? *(accommodation, food, per diem) Please explain:

( ) I received a scholarship from ________________

( ) My organization or institution will support my attendance
( ) An agency or funder is supporting my participation
( ) I will cover my own expenses
( ) Other___________________________________

*Note: Conference participation for the 3 days is free. For further information and assistance with
accommodation and travel arrangements please email yutex2010@gmail.com as soon as possible.

Emergency Contact:
Name : Telephone:

Emergency Contact:
Name : Telephone:

Before sending your application, re-name it as Myfirstname-mylastname.doc (e.g. John-

Smith). Please type the words Yute X Application in the subject line. A confirmation email
will be sent to all applicants.

Deadline for all applications: November 3, 2010

Successful applicants will be notified via email and telephone.
Applications will be accepted via email at yutex2010@gmail.com, or at the following
drop off points:
1. The Ministry of Health, 2-4 King Street, Kingston 2 (Yute X Box in the Lobby)
2. The National Centre for Youth Development, 16 A Half Way Tree Road
3. Marcus Garvey Youth Information Centre, Owen Sound Drive, St Ann
4. Ministry of Education, South Race Course Road, Mandeville
5. St. James Youth Information Centre, 1 Humber Avenue, Montego Bay
6. St. Mary Youth Information Centre, Ester District, Albany, St. Mary.
7. Portmore Youth Information Centre, Edgewater Round-about
8. Portland Youth Information Centre, 2A West Palm Avenue, Port Antonio
 Additional Conference Information
The Yute X Conference organizers will NOT cover transportation costs or international travel
expenses or accommodation. However, special rates are available for conference participants.

All youth ages 15-24 including Non-Jamaicans are encouraged to apply.

Remember Conference participation is free. There are no costs attached for registration.

Lunch and other Conference materials will be provided for all registered Conference participants
on all three days.

Visit our Conference website: yutexconference.com for details regarding logistics, special
features and the Conference programme. You may join our Yute X Facebook group as well as
the JYAN Interact profile where you will receive email alerts and regular Conference updates.

Yute X Contact information:

Yute X Secretariat
Jamaica Youth Advocacy Network
3rd Floor, Ministry of Health &Environment
2-4 King Street
Kingston 2
Tel: 876-922-9477
Fax: 876-967-1280
Email: yutex2010@gmail.com.

Volunteers urgently needed!

We are currently seeking persons who would like to volunteer for the Yute X Conference.
Please indicate your interest and availability emailing yutex2010@gmail.com, or by contacting
us at the Yute X Secretariat.

Kindly type the word Volunteer in the subject line.