Please complete the form below. All fields are required.
Personal Information: |
| Name: |
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| Gender: |
Male
Female |
| Address: |
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| City: |
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| State: |
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| ZIP: |
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| Home Phone: |
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| E-mail Address: |
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| Date of Birth (mm/dd/yyyy): |
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| Grade: |
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| School: |
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Rotary Club that sponsored you at your first RYLA Conference:
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Narrative:
Please answer the following questions in narrative form. |
1. Describe in detail any community service and/or leadership experiences in which you have participated since your participation the RYLA Conference.
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2. Through those experiences, how have you applied what you learned at the RYLA conference?
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3. The purpose of a RYLA Conference is to:
- Demonstrate Rotary's respect and concern for young people;
- Provide an effective leadership training experience for potential leaders;
- Encourage the leadership of young people by young people; and
- Recognize publicly young people who are rendering service to their community.
As a Student Facilitator, how would you role model and influence participants in order to fulfill the purpose of the conference? How would you communicate to participants the value of their experience?
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4. Imagine that you are the Student Facilitator of a group of 8-10 participants. It is the afternoon of the first day of the conference. Throughout the afternoon, participants in your group have had difficulty maintaining their focus and staying on task, so much so that you and your co-facilitators (a Manito-wish staff member and a Rotarian) feel that very little has been accomplished. Your group needs to further develop before it progresses to more challenging activities. Time is running short. As you are one of the group's facilitators, the eventual outcome reflects on you. How would you handle this situation? What would you do to ensure the success of your group?
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5. Describe your leadership style.
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6. What do you expect to get out of your experience as a Student Facilitator?
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7. What do you have to give to this year's RYLA Conference and its participants?
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8. To the best of your knowledge, can you fully commit to participating in the RYLA Conference from the morning of Thursday, September 9 to the afternoon of Sunday, September 12?
Yes
I'm not sure at this time, but I will know by:
(mm/dd/yyyy) |
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I certify that all statements made by me on this application are true to the best of my knowledge, and that I have not withheld any information that would, if disclosed, affect my application unfavorably.
I have read the Student Facilitator position description and I can, with reasonable accommodation, perform what I believe to be the essential elements of the leadership position for which I am applying.
I understand and accept the principles of the Rotary Youth Leadership Awards Conference as expressed in its purpose.
If 18 or order:
I agree to submit myself for a formal background check as sanctioned by Rotary District 6220 and understand that the results of which may impact my eligibility to participate in the conference. |
| Applicant Name: |
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Date: |
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By checking here, I agree to the above and understand my typed name serves as a signature. |
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