RYLA District 9790 Expression of Interest
This Expression of Interest for the Rotary Youth Leadership Award should only take you about 5 minutes to complete. We collect this information to help us connect you to a Rotary Club so that they can formally consider your interest and provide sponsorship.

You should expect to have to complete the following information:
-Your personal information including contact details and date of birth
-What you are currently doing for work and if you are contributing to your community - describe what you do
-If you have been in contact with a Rotary Club and their contact details if you have
-Your t-shirt size (in cm)

Contact Details
First name *
Your answer
Surname *
Your answer
Preferred name
Your answer
Address *
Make sure you include the number, street name, suburb/town, state and post code.
Your answer
Mobile Phone *
Your answer
Email *
Your answer
Date of Birth *
Make sure you set the year correctly. You MUST be over 18 to attend RYLA.
MM
/
DD
/
YYYY
Gender *
How did you find out about RYLA? *
If it's a person we need to know who they are as well!
Your answer
Are you able to attend RYLA in 2017?
The RYLA conference is happening from November 19 to 25, 2017. If you are not available we will hold your name and contact you again in 2018.
Have you attended RYLA before?
Let us know if you have attended the Rotary Youth Leadership Award before in any location around the world. This includes other in Rotary districts, multi-district and international RYLA events.
Next
Never submit passwords through Google Forms.
This form was created inside of Rotary International District 9790 RYLA.