Rotary Youth Leadership Awards
Iowa RYLA (Rotary Districts 5970 and 6000)
2019 RYLA/YRYLA Counselor Application
Application Deadline
The deadline for submitting Counselor applications is November 30, 2018. Head Counselors will conduct interviews in December and early January. Selection of Counselors will be announced on January 15, 2019.

Please provide a photo, a jpg file, by emailing it to Registrar@IowaRYLA.org.

Which RYLA? *
A new program, Young RYLA or YRYLA, for middle schoolers was held in 2017 and again in 2018. To be eligible to be a counselor at YRYLA 2019 an applicant must have attended Iowa RYLA. RYLA dates: Conference & Pre-conference -- 5:00 pm, July 13 to 3:00 pm, July 19; Training -- 5:00 pm, June 14 to Noon, June 16. YRYLA dates: Camp and pre-camp -- July 19, 5:00 pm to July 26, 4:00 pm; Training - 5:00 pm, Friday to Noon, Sunday, weekend date in June to be determined. I'm applying to be a Counselor at:
Local Rotary Club *
Select the name of the Rotary club that sponsored you for your RYLArian year.
First Name *
Your answer
Last Name *
Your answer
Nick Name
Enter name for your badge if other than your first name.
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email Address *
Enter an email address where you can be reached now and during the summer of 2018.
Your answer
Re-enter Email Address *
Your answer
Cell Phone *
Enter your cell phone number with area code i.e. 123-456-7890. If none, please enter a number where you can be reached.
Your answer
Birth Date *
MM
/
DD
/
YYYY
Gender *
Your response to this question will only be used to assign dorm rooms and will not be shared with anyone other than the RYLA Registrar who will receive this application.
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 *
Your answer
Current Grade *
College students -- please enter 13-16 for current year.
Your answer
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.
Your answer
Parents'/Guardians' email addresses
Enter parents' email addresses separated by a comma.
Your answer
Mom's Phone number
In the format 123-456-7890. Please provide phone number(s) where your mom can be reached during the day and evening, especially during RYLA / YRYLA events.
Your answer
Dad's phone number
In the format 123-456-7890. Please provide phone number(s) where your dad can be reached during the day and evening, especially during RYLA / YRYLA events.
Your answer
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”.
Your answer
Activity Restrictions *
Please identify any activity restrictions or write “None” if there are no activity restrictions.
Your answer
Who was your RYLA Counselor? *
Your answer
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. *
If you are applying for YRYLA or Either, please also describe the purpose of YRYLA.
Your answer
What is your proudest achievement since RYLA? *
Your answer
Why do you want to be a Counselor? *
Your answer
What are some of your strengths and how would they benefit you in the counselor role? *
Your answer
What else would you like us to know about you? (Leadership roles, accomplishments and extracurricular involvement; how they apply to being a counselor) *
Your answer
What does diversity mean to you? *
Your answer
Please provide your biography as you'd like it printed in the manual (250 words max). *
Please also provide a photo (a jpg file) by emailing it to Registrar@IowaRYLA.org.
Your answer
RYLA Counselor Applicants -- Training, Pre-RYLA, RYLA & Debrief
Counselors are expected to be present at Training, Pre-RYLA, RYLA and the Debrief.

Training will be conducted at Grinnell College from 5:00 pm, Friday, June 14 to noon, Sunday, June 16.

Iowa RYLA 2019 will be held July 14 through July 19 at Grinnell College. Pre-RYLA begins on Friday, July 12 at 5:00 PM and ends with the start of RYLA. Post RYLA officially ends with lunch and the completion of the mini-debrief on July 19 at approximately 3:00 PM. Counselors will be encouraged, but not required, to stay overnight, July 19 to rest and wind down before driving home.

The Debrief will be held on a Saturday a week or two after RYLA at Grinnell College.

Please complete and submit your application by November 30, 2018. Counselors will be selected by the head counselors and announced by January 15, 2019.

YRYLA Counselor Applicants -- Training, Pre-RYLA, RYLA & Debrief
Counselors are expected to be present at Training, Pre-YRYLA, YRYLA and the Debrief.

Training will be Held from 5:00 pm, Friday, to noon, Sunday, weekend in June and location to be announced.

Iowa YRYLA 2019 will be held July 21 through July 26 at Grinnell College. Pre-YRYLA begins at 5:00 pm, Friday, July 19 and ends with the start of YRYLA. Immediately after YRYLA a lunch will be served followed by a Debrief, which is expected to end by 4:00 pm on July 26.

Please complete and submit your application by November 30, 2018. Counselors will be selected by the head counselors and announced by January 15, 2019.

Applicant Signature
Thank you for completing your Counselor 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 or YRYLA training and conference or camp events listed above and make every effort to attend the RYLA or YRYLA Debrief.
Your answer
Are you 18 years old or older now? *
If not, your parent/guardian signature is also required.
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