Last Name:     First Name:

1.  Address 1:    
    

           Address 2:    
 

           City:                      State: State IL MO       Zip Code:
 

Home Phone:    Cell Phone  (if applicable):

E-Mail:

School: Select School Bishop DuBourg Cardinal Ritter Chesterfield Day Collinsville Crossroads DeSmet Fox Francis Howell Central Gateway Hazelwood Central Hazelwood East Home School Incarnate Word Jennings John Burroughs Lindbergh Kennedy (John F.) Kirkwood Maplewood-Richmond Heights Metro MICDS Nerinx Hall Other Parkway North Parkway South Pattonville Rosati-Kain S.L.U.H. Soldan International Studies St. Josephs University City Ursuline Academy Villa Duchesne Webster Groves       Class of: Select 2007 2008 2009 2010

Unlike many previous Civitas conferences, students will represent themselves and their peers, rather than sovereign countries.  There is no role playing; this is entirely your thinking and views based on your own personal experiences and research.

With whom would you like to room at the hotel? (You can list up to three people)

Do you have any special dietary requirement? Vegetarian?    Other?

Payment: $60

We need your payment one week before the conference. You can pay by check, money order, cash, or [new this year] credit card.  To pay by credit card, Click here to pay fee.

Financial aid is available. We want everyone to be able to attend, regardless of your ability to pay, so please let us know if you need financial aid. Talk to us, or call us at 314-367-6480.

 If you have any questions, please contact us, at (314) 367-6480, (314) 495-1720, or email us at info@civitas-stl.com.

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