Rotary Youth Leadership Awards
Iowa RYLA (Rotary Districts 5970 and 6000)
Sign in to Google to save your progress. Learn more
2022 RYLA Team Leader Application
Application Deadline
The deadline for submitting Team Leader applications is November 30, 2021. Selection of Team Leader is anticipated to be announced by January 31, 2022.
Which RYLA?
Young RYLA or YRYLA is a program for middle schoolers. To be eligible to be a team leader at RYLA 2022 or YRYLA 2022 an applicant must have attended Iowa RYLA.

RYLA 2022 dates: Conference & Pre-conference at Coe College or Grinnell College (decision on location expected November 5) -- 5:00 pm, July 15 to 3:00 pm, July 22; Training -- 5:00 pm, June 17 to Noon, June 19; and Debrief -- July 30 or August 6.

YRYLA 2022 dates: Camp at Waldorf University in Forest City -- July 8-12. The format for 2022 is slightly different from past years in that it begins on a Friday and ends on a Tuesday.
Which RYLA? *
I'm applying to be a Team Leader at:
Local Rotary Club *
Select the name of the Rotary club that sponsored you for your RYLArian year.
First Name *
Last Name *
Nick Name
If you would like a name in place of your first name on your badge, please indicate the name here.
Street Address *
City *
State *
Zip *
Email Address *
Enter an email address where you can be reached now and during the summer of 2021.
Re-enter Email Address *
Cell Phone *
Enter your cell phone number with area code in the format: 123-456-7890. If none, please enter a number where you can be reached.
Birth Date *
MM
/
DD
/
YYYY
Gender *
T-Shirt Size *
T-shirt sizes are generic cut sizes.
Polo Shirt Size *
If female, shirt size will be a woman's cut shirt unless you indicated otherwise.
Name of School *
Current Grade *
College students -- please enter 13-16 for current year.
Parents'/Guardians' Names *
In the immediate questions below, please provide names, email addresses and phone numbers where parents/guardians can be reached during the day and evening, especially during RYLA events.
Parents'/Guardians' email addresses
Enter parents' email addresses separated by a comma.
Parent/Guardian 1st Phone Number
In the format 123-456-7890. Please provide phone number(s) where you would like us to call first day or night should an emergency arise during RYLA events.
Parent/Guardian 2nd Phone Number
In the format 123-456-7890. Please provide phone number(s) you wish us to call day or night during RYLA events if we are unable to reach the 1st phone number(s).
Medical Conditions *
Identify any medical conditions we should know about, any medications currently being taken, any severe allergies, treatment for any allergic reaction, dietary restrictions or preferences, or write “None”.
Activity Restrictions *
Please identify any activity restrictions or write “None” if there are no activity restrictions.
Who was your RYLA Team Leader? *
Based on your experience, how would you describe the purpose of RYLA? If you are applying for YRYLA or Either, please also describe the purpose of YRYLA. *
What is your proudest achievement since RYLA? *
Why do you want to be a Team Leader? *
What are some of your strengths and how would they benefit you in the team leader role? *
Describe an experience where you have had to work in a team setting since RYLA. *
Why do you think you are the best candidate to be a Team Leader? *
What else would you like us to know about you? *
(Include leadership roles, accomplishments and extracurricular involvement and how they apply to being a team leader)
Please provide your biography as you'd like it printed in the manual (250 words max). *
Applicant Signature
Thank you for completing your Team Leader Application!
Code of Conduct *
I will abide by the RYLA Code of Conduct, RYLA Rules and I will break no laws. The decision of the Staff and Rotarians regarding rules infraction and discipline shall be final.
Required
Applicant Signature *
By typing your name below, in addition to confirming the agreements above, you agree to attend the entire RYLA training and conference events listed above and make every effort to attend the RYLA Debrief.
Are you 18 years old or older now? *
If not, your parent/guardian signature is also required.
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.