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BOLD CONFERENCE Student Registration

Sponsored by:

In partnership with

Introduction Greetings, We are pleased to announce that Leadership At Its Best, LLC will host, in partnership with The Black Women’s Expo 2014 in Chicago, its Leadership and Life Skills Conference for 100 - 150 African-American middle and high school young women & young men. The Conference is entitled BOLD - Black-student Orientation to Leadership Development. Within the present social services systems of our country, African-American students continue to be the victims rather than the victors. As victims, African-American young people continue to be subjected to policies, instructional strategies, and human attitudes that result in growing social alienation, frustration and failure. Ultimately, the victim’s status causes unemployment, unstable lives and aggravation of urban problems - drugs, crime, gangs, vandalism, school dropouts, in other words, “self destruction”. All of this impacts our current and future workforce, for we must have well trained and talented citizens for our city and America to grow. The BOLD Conference is designed to develop an awareness of the importance of education, positive African-American leadership, understanding the importance of community and having a strong positive self-image. Our young people must be taught to think and act like they are, BOLD Winners! See the schedule of events for times. We are excited about hosting the BOLD Conference and we invite you to be with us as our guest, there is no charge; it is FREE. And we know it will be a fun filed experience. To attend you must complete the attached application and have your parent(s)/guardian(s) and school/organizational sponsor complete their section and return it to us. If you have any questions please call our BOLD Conference Director of Programs Mr. Randy Butler at 614-404-8979 or email him at We thank you in advance for your support!

Carter D. Womack

Merry Green

President & CEO Leadership At Its Best, LLC 614-264-7599 Office

President The Black Women’s Expo & MGPG Events, Inc. 312-454-6100 Office

Schedule of Events REGISTRATION 9:00am – 9:35am

LEARNING SESSION III 2:45pm – 3:45pm

OPENING SESSION 9:35am – 10:15am

FEEDBACK/CONTRACT SESSION (conducted by youth participants) 4:15pm - 5:00 pm

LEARNING SESSION I 10: 20am –11:10pm LEARNING SESSION II 11: 15am –12:05pm LUNCH (Motivational Speaker) NOON - 1:00pm TOWNHALL MEETING 1:15pm – 2:30pm

TOUR of the EXHIBIT FLOOR 5:00 pm -6:00 pm Depart for home with parent(s) or guardian(s)


Registration Form for the BOLD Conference Register now and attend the BOLD Conference and be eligible to WIN Great Prizes and Gifts –such as: gift cards, movies passes and more! (For conference use only - all information will be kept confidential) • Print only

STUDENT & PARENT INFORMATION [print only] Student’s Name: _________________________________________ Grade: ______________________________________ Address: ______________________________________________________________________________________________ City: _____________________________________ State: _____________________ Zip: __________________________ Home phone: (_______) __________________________________ Cell: (_______)________________________________ Email: ________________________________________________________________________________________________ Parent’s Name: ___________________________________________ Email: ______________________________________ Work phone: (_______)___________________________________ Cell: (_______)________________________________

SPONSORING SCHOOL/ORGANIZATION INFORMATION [print only] Organization’s Name: __________________________________________________________________________________ Contact Person: _______________________________________________________________________________________ Address: ______________________________________________________________________________________________ City: _____________________________________ State: _____________________ Zip: __________________________ Phone: (_______) _________________________________________ Email: ______________________________________

PARENTS APPROVAL [print only] Print Name: ___________________________________________________________________________________________ Address: ______________________________________________________________________________________________ City: _____________________________________ State: _____________________ Zip: __________________________ Phone: (_______) _________________________________________ Email: ______________________________________ I will stay for the parents workshop session and for lunch: yes______ no_____ Signature: ______________________________________________ Date: _______________________________________

PHOTO RELEASE FORM I, ______________________________________________________ (please print), grant permission to Leadership At Its Best/BOLD Conferencec to reproduce the photographs or video taken of me, or members of my family, for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I acknowledge that I am:

[ ] over the age of 18

[ ] the legal guardian of the following

If legal guardian of underage child, please list name(s) here: _________________________________________________ Signature: _________________________________________ Date: _____________________________________________ Address: ______________________________________________________________________________________________

Return to: This registration form must be returned to your school/sponsor organization advisor.

The Issues That African-American Children Face Impact All Communities

10 BOLD Facts


Every 46 seconds of the school day, an African-American child drops out of school. 2. The high school Graduation rate for African-American males is only 42% 3. Every 65 seconds an African-American teenager becomes sexually active (for the first time). 4. Every 11 minutes an African-American child is arrested for a violent crime. 5. Every 18 minutes an African-American child is arrested for a drug offense. 6. Every 76 minutes an African-American child is arrested for an alcohol-related crime. 7. Every 4 hours an African-American child is murdered. 8. Every 6 hours an African-American child dies from firearms. 9. Every 20 hours an African-American child or young adult under 25 dies from HIV. 10. Every 2 days an African-American child commits suicide. African-American males are most affected by all of these facts. If change is to occur, new and BOLD steps must be taken. Data source: Children Defense fund and educational report on graduation rates

About Leadership At Its Best, LLC Columbus, Ohio Leadership At Its Best, LLC is a Columbus, Ohio based company that provides leadership and development training, and diversity strategy planning to corporations and businesses. We also offer leadership and development training for college and university students and our pre-college programs for students in public and charter school districts. Our client list includes: Alabama A & M University, The Ohio State University, The University of Toledo, Central State University, Hinds Community College, Ole Miss – The University of Mississippi, Jackson State University, Shaw University, The Thurgood Marshall Scholarship Fund, Phi Beta Sigma Fraternity, Inc – Leadership Institute-Columbus Ohio Public Schools Student Leadership, Leffore County Schools, Leffore, MS. African-American Male High School Leadership Program, Columbus, Ohio, African-American Male High School Leadership Program, Los Angeles, CA, Crystal Stairs, Inc, Kellogg’s, The Newark New Jersey Public Library System, Salesian Boys & Girls Club, BOLD Conference, Detroit, Michigan, Dayton, Ohio, Columbus, Ohio, BOLD Institute – Charter Schools, Columbus, Ohio and Detroit, MI. Leadership At Its Best

947 East Johnstown Road Suite 258 Columbus, OH 43230 Phone: 614-264-7599 Fax: 614-939-3254 REV DATE 1.2.14

Bold bwe student registration 2014  

Attached please find materials, pertaining to the B.O.L.D. leadership conference scheduled to launch as an introduction to Chicago via the B...