"I Dare You!" Scholarship Application

Congratulations on receiving the National Leadership Award! As an award winner, you are eligible to apply for an "I Dare You!" Scholarship to attend the AYF Leadership Conference. The $425 scholarship will be applied toward the tuition of the AYF's Leadership Conference.

This online application contains 3 short sections and should take you approximately 20 minutes to complete. You may save your work at any time using the option at the bottom of the page and return to complete the form later. Fields that are required are marked with a red asterisk (*). All required fields must be completed in order to submit your application.

If you have any trouble with this form, please contact us at AYF, Miniwanca, 231-861-2262. Thank you for your interest in our programs. We look forward to receiving your application.

Applicant Information

Please complete the following information about yourself.

Enter your first name

Applicant First Name*

Enter your last name

Applicant Last Name*

Enter your birthdate in format mm/dd/yyyy

Applicant Birthdate*

Enter your 1-2 digit grade in school for the 2006-07 year; for post-high school, enter 13

Applicant Grade*

Enter your street address

Applicant Address1*

Enter additional address line

Applicant Address2

Enter your city

Applicant City*

Choose your state (US)

Applicant State

Choose your province (Canada)

Applicant Province

Choose your country

Applicant Country*

Enter your postal or zip code

Applicant Postal Code*

Enter your full phone number, including area code

Applicant Phone Number*

Enter your Email address

Applicant Email Address

Organization Information

Please complete the following information about the organization from which you received your "I Dare You" Award.

Enter date you received your "I Dare You" award

Date Award Received*

Enter the name of the organization

Organization Name*

Enter organization county

Organization County*

Enter organization street address

Organization Address1*

Enter additional address line

Organization Address2

Enter organization city

Organization City*

Choose the organization state (US)

Organization State

Choose the organization province (Canada)

Organization Province

Choose the organization country

Organization Country*

Enter organization postal or zip code

Organization Postal Code*

Enter the full name of the organization contact

Contact Name*

Enter the contact phone number

Contact Phone*

Essay

Please submit a 500-word, or less, essay highlighting your accomplishments, demonstrated leadership qualities, community service history, and why you should be chosen to receive an "I Dare You!" scholarship to attend the AYF's Leadership Conference.

Type Essay Here*

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