GLC Registration: Registering Yourself

This form is for registering only yourself. Also use this form only if you’re not a staff member at a JA regional operating center (ROC).

If you’re registering others, please return to the GLC registration landing page and choose “Registering Others." If you’re part of a JA ROC, regardless of how many staff you’re registering, return to the GLC registration landing page and choose “Registering ROC Staff.”

Ready to begin? Dive in! Once you’ve completed the form and click "SUBMIT," you'll be taken to the checkout page.

The official name of your JA location

For example, INJAZ Bahrain, Young Enterprise Northern Ireland, Prestasi Junior Indonesia, JA of San Diego County

Your name

Please write your name as it is shown on your passport

First Name

Last Name

Your email

My supervisor has approved my attendance at GLC.

Yes

No (if "No," please stop, obtain the required permission, and return here to register)

Your supervisor's name and job title

Your supervisor's email

Name for nametag

Please write your name as you would like it displayed on your GLC nametag

Job title for nametag

Single room or shared?

Conference fee (per person per room), including hotel room and meals, is US$680 per person for a single room and US$550 per person for a shared room. Fee does not include airfare, airport transfer, and one dinner on your own.

Single room

Shared room (you must name your roommate, below)

Name of roommate

Dietary restrictions?

We'll do our best to offer as many options as possible and encourage you to bring your own snacks to augment.

Do you require an accommodation (for example: sign language interpreter, wheelchair access, active-listening device, closed-captioned videos, and so on)? If so, please list your needs in the space below.