DelegateNomination - Evergreen Boys State

Thank you for nominating students to attend Evergreen Boys State in June. Please fill out the below form and a member of the Program Staff will contact them to assist with the registration process.

Member Submitting Nomination:*

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Last

Member's E-mail:*

Member's Phone:*

Area Code

Phone Number

Student's Name:*

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Last

Address:

Street AddressCityState / Province / RegionPostal / Zip Code

Student's Phone:

Area Code

Phone Number

Student's E-mail:

Student's High School:

Save the date for our 2024 session on June 16-22, 2024.