Online Application / Nomination Form Who is submitting this form? Applicant - I have not yet been nominated by a sponsoring Rotary Club - please help me find one. Applicant - I have not yet been nominated by a sponsoring Rotary Club, but I know which club through which I am applying (listed below). Nominee - I have already been selected by the sponsoring Rotary Club listed below and have been directed to complete this form. Sponsor - I am a sponsoring Rotary Club POC, submitting this form on behalf of our nominee. Applicant / Nominee's First Name * Middle Name * Last Name * Email * Primary Phone * (###) ### #### Secondary Phone (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Physical Address If different from mailing address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth MM DD YYYY Gender * F M Non-binary T-shirt Size * S M L XL XXL XXXL Current Employment * Education Completed * Volunteer Activities * Leadership Activities & Achievements * Why do you wish to attend RYLA? * Sponsoring Rotary Club * Enter "TBD" if applicant needs assistance finding sponsoring club Rotary Club Point of Contact's (POC) Name POC Email Sponsoring Rotary club POC's email POC Phone Sponsoring Rotary club POC's Phone (###) ### #### Comments The registration form has been submitted. Please visit the following link to complete payment: link coming soon.
