Welcome
Rotary Youth Program of Enrichment (RYPEN) Camp Application
Section One: Personal Information
Name: ____________________________________________________ Date of Birth: ____________
Address: ___________________________________________________ Postal Code: ____________
Telephone #: ( ) _____________________________ E-mail: ______________________________
Current Grade: _____________________
Section Two: Reason for Applying
Attach a short rationale (200 words or less) why you want to attend the camp and what you want to get out of the experience.
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Section Three: Community Service
List any community service or volunteer school activities in which you have been involved.
Name of community/school organization or club When What you did
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Section Four: Letters of Reference
- Attach two letters of reference to this application
- Letters should include comments on applicant’s personal qualities and service activities.
__________________________________________________ ___________________
Applicant Signature Date
__________________________________________________ ___________________
Parent/Guardian Signature Date
Please forward your completed application to the Interact Teacher Supervisor.
Interact Teacher Supervisor Signature: ______________________________________
Supervisor Signature indicates that the applicant is a student in good standing within the school community and would be a suitable representative of Harry Ainlay School and the Rotary Club of Edmonton Gateway.