WHO: New Mexico Foster youth ages 16-21 WHEN: August 3-5, 2009 WHERE: Sagebrush Inn-Taos, NM

1. Independent Living Youth Conference 2009 generation transformation WHO: New Mexico Foster youth ages 16-21 WHEN: August 3-5, 2009 WHERE: Sagebrush Inn-Taos, NM WHAT: Life Skills Workshops, Swimming, Dancing, Art, Hip Hop, National Speakers & Socializing This is a FREE event that will offer lots of fun, socializing, meals, door prizes, T-shirt and a bag full of gifts! COME JOIN US!

2. Agenda Monday, August 3rd: 1:00-3:00 p.m. Registration – Sagebrush Inn 3:15-3:30 p.m. Review of Conference Expectations 3:30-5:15 p.m. Relax, Swim and Unpack 5:15-5:30 p.m. Check in with Chaperones 5:30-6:30 p.m. Dinner 6:30-7:30 p.m. Foster Club 7:30-7:45 p.m. Check in with Chaperones 8:00-9:30 p.m. Opening Speaker 9:30-10:30 p.m. Hip Hop 10:30-10:45 p.m. Check in with Chaperones 11:00 p.m. Lights out Tuesday, August 4th: 8:00-9:00 a.m. Breakfast 9:00-9:15 a.m. Check in with Chaperones 9:30-10:30 a.m. Workshops 10:30-10:45 a.m. Break & Snacks 10:45-11:45 a.m. Workshops 11:45-12:00 p.m. Break 12:00-12:45 p.m. Lunch 12:45-1:00 p.m. Check in with Chaperones 1:00-2:00 p.m. Workshops 2:00-2:15 p.m. Break 2:30-3:30 p.m. Workshops 2:30-3:30 Taos Pueblo 3:30-5:30 p.m. Swim, Video Games or Karaoke 5:30-5:45 p.m. Check in with Chaperones 6:00-6:45 p.m. Dinner 7:00-8:oo p.m. Relationship Building 8:00-8:15 p.m. Check in with Chaperones 8:15- 10:30 p.m. Dance discussion & Dance 10:30-11:30 p.m. Karaoke 11:30-11:45 p.m. Check in with Chaperones 12:00 a.m. Lights Out Wednesday, August 5th: 8:00-8:45 a.m. Breakfast 8:45-9:00 a.m. Check in with Chaperones 9:00-10:00 a.m. Closing Speaker-Mark Anthony???? 10:00 a.m. Sack Lunch and Farewell

3. Rules & Expectations Please read, initial each item and sign your name stating you agree with the rules and will honor them. __ 1. I will not sneak out of my room at night. __ 2. I will not allow any outside guests or visitors in my room. I understand that youth of the opposite sex are not allowed in my room without staff present. __ 3. I will not switch my rooms without first getting permission from CYFD staff/chaperone. __ 4. I will not bring or use alcohol, drugs, fireworks, firearms, pocket knives, or weapons of any kind. If I see anyone breaking this rule, I will report it immediately. __ 5. I will be responsible for all my personal property. __ 6. I will respect others’ personal property and personal space, which means I will keep my hands to myself. __ 7. I will not leave the conference site for any reason unless it cleared and coordinated with staff in advance and I have CYFD staff with me. __ 8. I will be respectful of others and treat others how I would like to be treated. __ 9. I will not kiss, engage in other public displays of personal affection, or have any kind of sexual activity with others during the conference. __ 10. I will wear appropriate clothing. __ 11. I will not get physically or verbally violent. __ 12. I will respect the speakers while they are presenting. __ 13. If I break any of the above stated rules, I understand that I may be excluded from the remainder of the activities and may be required to leave early. 14. I will let my youth services consultant know if I am on medication. Youth Signature Date

4. PLEASE PRINT (Please give full name and contact phone number) Foster Parent/Caregiver: ___________________ Phone Number: __________________ CYFD Social Worker: ______________________ Phone Number: __________________ Youth Services Consultant: _________________ Phone Number: __________________ Probation Officer: _________________________ Phone Number: __________________ Independent Living Youth Conference 2009 Application TRANSPORTATION (talk to your Youth Services Consultant if you need transportation) My transportation to and from the conference will be provided by : ____________________________ MEDICAL INFORMATION Please attach a copy of your Medicaid Card Medicaid Plan: ____________________ Medicaid ID Number: _______________ Medication: □Yes□ NoType/Name and Dosage:______________________________ Special Medical Needs: □ Allergy □ Heart □ Diabetes □ Insect Bites □ Epilepsy □ Pregnant □ Handicap □ Other: Special Dietary Needs: ______________________________________________ Please describe any of the above or additional special needs on a separate sheet of paper & submit with this application Name: ______________________________ Gender: □ Female □ Male Address: _______________________________________________________________ Phone: __________________Email: ____________________Birth Date: _______________ Name of Person You’d Like to Room with at the Conference:_______________________ (It’s okay to not put anyone down. We will match you with the right peer!) Please indicate T-shirt Size: (Adult Sizes) _ Small _ Medium _ Large _ X-Large _ XX-Large _ XXX-Large PLEASE SIGN & DATE I have read and understood and agree to abide by the Rules & Expectations. ________________________ _________________ Youth Signature Date MAIL You may mail or fax to: FAX New Mexico State University ATTN: Gloria Nuñez School of Social Work (575) 646-4116 ATTN: Gloria Nuñez P.O. Box 30001/MSC 3SW Las Cruces, NM 88003-8001 DEADLINE to submit applications is July 15