Orange County Youth Leadership America Fall Program Application

FAll Applications are CLOSED

* Any applications received after the due date listed above will be declined. Applicants that are accepted for the Summer Program will also be accepted for the Fall Program and are required to do both. Applicants that are not accepted into the Summer Program will be deferred and considered for the Fall Program. Accepted applicants will receive further information about payment to reserve place. All applications are final and cannot be changed after submission. If you have any questions, please contact Ruben Sanchez at rsanchez@ylamerica.org 


Name *
Name
Gender *
Ethnicity *
Check all that apply.
Address *
Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Sell YLA to a possible Sponsor
Guardian 1's Name *
Guardian 1's Name
Guardian 1's Cell Phone Number *
Guardian 1's Cell Phone Number
Guardian 2's Name
Guardian 2's Name
Guardian 2's Cell Phone Number
Guardian 2's Cell Phone Number
Will any of your extracurriculars conflict with YLA's events? *
YLA creates weekly events on Wednesdays from 6 PM - 8 PM and several Saturday events for our fall and summer program.
Have you attended a YLA Public Event? *
If so, which one(s)?