Rotary Youth Leadership Awards Conference

Please complete the form below. All fields are required. Personal Information:
Name:
Gender:	Male Female
Address:
City:
State:
ZIP:
E-mail Address:
Date of Birth: (mm/dd/yyyy)
Grade:
School:
Sponsoring Rotary Club:

Narrative:
1. Why would you like to attend the RYLA Conference?
2. List any extracurricular, community service and/or leadership experiences in which you have participated/are currently participating.
3. What does leadership mean to you?
4. To the best of your knowledge, can you fully commit to participating in the RYLA Conference from the morning of Friday, September 10 to the afternoon of Sunday, September 12? Yes I'm not sure at this time, but I will know by: (mm/dd/yyyy)