Rotary Club Sponsorship Agreement Form

"Service Above Self," the Heart of Leadership

Rotary Clubs are invited to sponsor current High School Sophomores or Juniors

to attend the Rotary District 6690 RYLA Conference.

Student's names are not yet required....only a commitment by your Rotary Club to identify and sponsor students is needed by March 29th and payment by April 30th.

Rotary Club Information

By completing the information below your Rotary Club is agreeing to identify and sponsor the attendance and participation of one or more local students at District 6690's Rotary Youth Leadership Conference. Cost per student participant is $150.00 - due within 30 days of completion of this form.

Rotary Club of *

Club President, First Name *

Club President, Last Name *

Preferred Mailing Address *

City *

State *

Postal Code *

Club President, Phone *

Club President, Email Address *

Rotarian RYLA - Club Contact First Name *

Rotarian RYLA - Club Contact Last Name *

Cell Phone *

Other Phone

Email address *

Address *

City *

State *

Zipcode *

Our Rotary Club agrees to sponsor students as shown and to submit payment within 30 days of completion of this form to the address shown below. *

Rotarian RYLA Club contact may be someone other than the Club President.
Their responsibilities include:
--Selecting participants
--Remaining in contact with RYLA Committee
--Submitting participants' data by required deadlines
--Remaining in contact with selected RYLA participants through and after the conference
--Confirming participants transportation arrangements to/from the conference
--Invite participants to Rotary Club Meeting

By submitting this form the Rotary Club named above understands and agrees that all payments made are non-refundable and that should their participant be unable to attend an alternate will be chosen to take their place.

Final deadline for receipt of this Club Sponsorship Agreement Form is March 29th.

IMPORTANT NOTES: Please read carefully.

Rotary Clubs may sponsor current High School Sophomores or Juniors for this award.

Participants names are not required at this time. However we ask that your Club kindly submit the name(s) and information of your selected participants by May 1st.

RYLA event is limited to a maximum of 96 student participants.
Submissions received with payment will be handled on a first come first served basis.
Once we have reached maximum capacity we will be unable to accept additional forms and/or payments.
No exceptions will be made.
Rotary Club's are encouraged to complete and submit this form along with payment as soon as possible (prior to deadline) to guarantee and hold the space.

Payment is due within 30 days of submission of this form.

Payments are non refundable.

Please make checks payable and mail payment to:

Rotary District 6690 Treasurer

John Vogelpohl

PO Box 387

Hilliard, OH 43026

Additional information on selecting your club's student RYLA participant(s) will be sent to participating Rotary Clubs in April.

Any questions please email us at msowers@jacksoncitylibrary.org

Thank you
Melissa Sowers, RYLA Chair

Your information has not been submitted until you click SUBMIT..

updated 02/20/2024

One student $150.00	Two students $ 300.00	Three students $450.00
Four students $ 600.00	Five students $750.00	Six students $ 900.00
Other Other