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RYLA 2023 Participant Application
Rotary District 5100
Rotary Youth Leadership Awards
Menucha Retreat Center, Corbett, Oregon
July 8-14, 2023
APPLICANT MUST BE BETWEEN 19 AND 32 YEARS OF AGE ON JULY 8, 2023.
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Do you have a sponsoring Rotary club?
*
Yes
No
If yes, what club?
Your answer
Who is the Rotarian you are working with?
Your answer
Name
*
First and last name
Your answer
Pronouns
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Gender
*
Menucha has dormitory style rooms. This response is used to place participant in male or female identifying rooms.
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Email
*
Your answer
Phone number
*
Your answer
Preferred Contact Method
*
Email
Phone
Text
Required
Mailing Address
*
Your answer
Unisex T-Shirt Size
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XS
S
M
L
XL
XXL
Tell us about what you are currently doing? (Going to school, in your career, etc)
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Your answer
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