We would love to hear from you! Kappa Xi Chapter of Omega Psi Phi Fraternity, Inc. P.O. Box 270226 Las Vegas, NV 89127 (775) 285-7045 For more information and to register for the Youth Leadership Conference, complete the online form below. Please enable JavaScript in your browser to complete this form.Name *FirstLastAge *Grade *Address *City *State *Zip/Post Code *Parent/Guardian Name *FirstLastParent/Guardian Cell Phone *Parent/Guardian Email *Are you attending as a male or female parent/guardian? *FemaleMaleStudent: Brief description of yourself & future goals School you attend *Have you ever attended a Youth Leadership Conference? *YesNoAre you a part of a youth group – on campus, in the community or faith-based? *Why did you join that group (those groups) and what benefits do you receive? Do you plan to attend college? *YesNoWhy are you attending the 77th Annual Twelfth District Meeting YLC Program? What do you hope to gain from attending? *Submit