2021 RYLA - Rotary District 5790
REQUEST for APPLICATION ~~DEADLINE: May 1, 2021~~
Email address *
The 2021 RYLA application process has THREE steps!
STEP 1) Student completes and submits the online Request for Application (RFA).

STEP 2) RYLA application emailed to Student. Student and Parents complete, sign and return the full application.

STEP 3) Local Rotary Clubs select and approve students for sponsorship to RYLA 2021.

The 2021 District 5790 RYLA Leadership Program will be held at Tarleton State University June 17th-20th, 2021. After you submit this Request for Application, a full APPLICATION will be forwarded to the email addresses submitted on this form. After you return the completed full APPLICATION, the local Rotary Club will review and select students approved for sponsorship to RYLA 2021.

Rotary District 5790 is taking precautions to ensure the safety of campers and staff. Coronavirus protocols and procedures for Camp RYLA will be published May 1, 2021.
First Name *
Your legal first name (William, Rebecca, Charles, etc.)
Badge Name
What name would you like printed on your camp badge? (Bill, Becky, Chuck, etc.)
Last Name *
Legal last name.
Attended RYLA in a previous year? *
Students may only attend RYLA one time as a Camper.
Gender *
Grade Next Year *
Students MUST be a Junior or Senior in the fall of 2021.
Date of Birth *
Student must be 16 by July 1, 2021
MM
/
DD
/
YYYY
Student Cell Phone *
Student cell phone number or another working contact number. (no symbols please 8175336792)
Parent Name *
Enter your parent or guardian's full name.
Parent Email *
You MUST submit a valid parent/guardian email address to receive an application for RYLA.
Home Phone *
Student home phone number or another working phone contact number. (no symbols please 8175336792)
Parent Work Phone
This is optional. (no symbols please 8175336792)
Parent Cell Phone
This is optional. (no symbols please 8175336792)
Street Address *
EX: 1224 W. Main St.
City *
State *
Zip Code *
EX: 76033
High School *
School you are attending now.
Shirt Size *
What size T-Shirt do you wear?
Interact Club Member? *
Are you a member of an Interact Club?
Club Invitation
If a local Rotary Club invited you to complete this RFA, please list the name of the Club. (Abilene, Arlington, Cleburne, Mansfield, etc.) An invitation is NOT required to apply.
Why Leadership? *
Why do you want to learn more about Leadership?
Agree to attend *
If you are chosen for a RYLA sponsorship, your local Rotary Club will pay a sponsorship fee of $425 to secure your spot for the 2021 RYLA camp. The RYLA experience is like no other! If you have a conflict such as a vacation, another camp or summer sports, please DO NOT complete this RFA.
Thank you for your interest!
A full APPLICATION (PDF) will be forwarded to the email addresses listed above.The APPLICATION must be completed, signed by a parent or guardian, and returned via mail or email. Forms must be printed or completed electronically so the original formatting is not altered or removed. SUBMITTED FORMS THAT HAVE REMOVED OR ALTERED THE ORIGINAL FORMATTING WILL NOT BE ACCEPTED. Email and mailing address will be provided on the APPLICATION. The local Rotary Club in your area may contact you to schedule an applicant interview or discuss your APPLICATION. If you are not contacted by a representative of the local Rotary Club by May 15, 2021, you may email info@RYLA5790.org for further instructions and information.
A copy of your responses will be emailed to the address you provided.
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