RYLA Application

2018 Great Plains RYLA, July 18-22

We are excited that you’ve visited the application page.  Please check back very soon to fill out your application to RYLA by March 24th 2018, 11:59 PM.  When you submit an application, it will be reviewed by the District 5630 RYLA Committee and you will be scholarships to the 2018 RYLA will be awarded soon.

We will be looking forward to welcoming you to Halsey, NE and the Great Plains Rotary Youth Leadership Awards Camp on July 18, 2018.

Personal Data

Special Information Needed

The information in this section will only be used if you are accepted to the Great Plains RYLA program. It will also not appear on the application that will be reviewed.
Please indicate how you want your name to appear on your name tag. No nicknames. (If you name is Jonathan, but you go by Jon, then indicate Jon. If you first name is Jerry, but you go by your middle name Andrew, then indicate Andrew.
Do not include allergies to medication or environmental factors
You will indicate allergies to medication, things in nature, etc. on the medical form you will submit later

Parent/Guardian Information

This information will only be used if you are accepted to the Great Plains RYLA program.

Emergency Contact Information (Someone other than a parent not living in the same home)

This information will only be used if you are accepted to the Great Plains RYLA program.

Vision

Past and Current Experience

If you select "Yes," you will enter additional information.
If you select "Yes," you will enter additional information.
Include Employer: Dates: Job Duties:
If you select "Yes," you will enter additional information.
Be sure to include: Organization/Activity: Grade(s): Leadership Responsibility/Involvement:
If you select "Yes," you will enter additional information.

Applicant Commitment

You will be asked to download, print out, and sign a Commitment Form after submitting this application. This is to be sent to your RYLA Representative for your local Rotary Club. It must be sent within one week of completing the application. If this form is not received, your application will be considered incomplete and will not be considered.
IF YOU ARE SELECTED AND THEN ARE UNABLE TO ATTEND RYLA, YOU WILL BE RESPONSIBLE FOR 1/2 OF THE CAMP FEE (OR $200) TO YOUR SPONSORING CLUB.OF CAMP.
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