REGIONAL YOUTH LEADERSHIP
CLASS OF 2016
2015 - 2016 APPLICATION
Since 1995, Regional Youth Leadership (RYL) has been preparing our community’s most important resource… our
future leaders! RYL is a non-profit, leadership development program for high school juniors in the Northern
Kentucky/Greater Cincinnati area. During the eight-month program, students explore complex issues and challenges
faced by the region through interaction with leaders from businesses, government agencies, and civic organizations
in the community. RYL uses the community as the classroom to provide participants new challenges and
opportunities for intellectual, creative, social and personal growth. Graduates are motivated and empowered to
assume leadership roles and influence the direction of our region’s future.
Program sessions are held monthly during the school day from August through March. Each session is held at a
different business or organization and led by community business leaders on the following topics.
 Retreat
 Health
 Criminal Justice
 Diversity
 Law
 Local Government &
Economic Development
 Life Success Skills
 Arts & Culture
The goal of each day is to increase students’ knowledge and expose them to issues and resources surrounding the
topic in a very interactive and innovative manner. During the sessions, students practice their leadership skills, public
speaking, decision making and problem solving, negotiating, listening, team building, networking and learn to step
out of their comfort zone.
Regional Youth Leadership
PO Box 17416
300 Buttermilk Pike, Suite 330
Ft. Mitchell, KY 41017
www.nkychamber.com
Services > Leadership Development
Program Director – Ann Marie Whelan
859-578-6398 / amwhelan@nkychamber.com
REGIONAL YOUTH LEADERSHIP
PROGRAM INFORMATION AND APPLICATION INSTRUCTIONS
Dear Applicant:
Congratulations on your decision to apply for Regional Youth Leadership Class of 2016! Forty-five to fifty high school sophomores will be
selected to participate in this eight-month program during their junior year.
Before beginning the application, please read the following information carefully. All applicants should consult a parent/guardian and
school contact (guidance counselor or principal) before applying. The cost of the program includes a $100 school participation fee
payable by August 30, 2015 (which is normally covered by the school). There is a $10 non-refundable application fee to be included with
each application. If a school or student needs assistance with the fee, they should contact our office.
Eligibility – Applicants must:
 be a current sophomore with a minimum GPA of 3.0.
 demonstrate leadership potential in their school and/or community.
 have an interest in furthering their knowledge about our region and community leadership.
 receive approval by high school principal and/or guidance counselor.
 commit to full participation in the program including a reflection essay, timely responses to email and attend a
mandatory retreat on September 13, 2015.
Student Commitments:
 Students are responsible for transportation to and from sessions.
 Attend monthly sessions / September-March, 7: 45 am - 3:00 pm / Monday-Friday—the day varies, one per month.
 Exceptions:
o Orientation is normally held in the evening in August.
o Opening Retreat will be held on Sunday, September 13.
o Graduation is normally held on a Sunday afternoon in March.
 Attendance at all sessions is expected. Two or more unexcused absences will result in removal from the program. Being accepted
for RYL is similar to signing a contract, both sides have obligations. You will agree to contribute your presence, ideas and energy,
and we agree to challenge you and expose you to new ideas. Plus, you owe it to your school (who may be footing the bill) to get
the most out of the experience as you can.
 The Opening Retreat on Sunday, September 13, 2015 is mandatory.
Application Requirements:
 Fill out the application completely.
 Please TYPE! The application is a Word document that can be downloaded from www.nkychamber.com > Services > Leadership
Development. Complete, save and print.
 Sign the application.
 Obtain parent/guardian signature.
 Attach $10, non-refundable application fee. Checks can be made payable to Regional Youth Leadership.
 Submit signed application to school for approval by March 1, 2015 or date requested by school official.
 Your school must review and submit your application no later than March 13, 2015.
Selection Process:
 All applications will be reviewed by the RYL Steering Committee who will consider a number of criteria. Please provide thoughtful
responses to the application questions.
 The committee will be seeking representation from a cross-section of the community and their decision will be based upon
information contained in the application. They will be looking for a diverse group of students to provide the richest experience
possible for participants. At least one student from each school that applies will be selected.
 All applicants will be notified of the status of their application by May 1, 2015.
Please feel free to contact me if you have any questions. You can reach me at 859-578-6398 or amwhelan@nkychamber.com. Best of
luck with your application!
Sincerely,
Ann Marie Whelan
RYL Program Director
Please retain this page for your records.
REGIONAL YOUTH LEADERSHIP 2015-2016 APPLICATION
Send completed application to:
Regional Youth Leadership
c/o Northern Kentucky Chamber of Commerce
PO Box 17416
Ft. Mitchell, KY 41017-0416
Application must be postmarked no later than March 13, 2015.
Call or email questions to Ann Marie Whelan at 859-578-6398 or amwhelan@nkychamber.com
$10 application fee attached. If Checks may be made payable to Regional Youth Leadership.
Please check here if you are unable to pay the application fee and are requesting that it be waived. This will not
affect your chances of being selected in any way.
$100 school participation fee attached and made payable to Regional Youth Leadership
Please check if you would like us to invoice your school in August (if you prefer to pay out of next year’s school
budget)
APPLICANT INFORMATION
This application is a fillable form in Microsoft Word. Please type your responses.
Name:
First
Name you prefer to be called
Last
Address:
Street Address
Apartment/Unit #
City
Home Phone: (
State
)
Student Cell Phone: (
)
ZIP Code
E-mail Address:
OPTIONAL PERSONAL DATA
Gender:
male
female
Date of Birth
Are you Hispanic or Latino?
How would you describe yourself? Select one or more of the following.
American Indian
Black or African American
Asian
Native Hawaiian or Pacific Islander
Have you attended Camp Joy previously?
yes
no
If yes, how old were you when you
attended?
Did you participate in a high ropes activity?
yes
no
List up to five school related activities in which you have participated during the last four years.
Years
no
White
ACTIVITIES
Name of Club/Organization/Sport
yes
Your Role
List up to five non-school related activities in which you have participated during the last four years.
Name of Club/Organization/Sport
Years
Your Role
If you haven’t had the opportunity to participate in such activities, why not?
Time
Not Interested
Work
Financial Reasons
What is your main interest of studies?
QUESTIONS
Maximum 250 words per question. Please type your responses. You may attach an additional sheet if necessary.
What are three characteristics of an effective leader? Why are these characteristics important?
Name a specific time you were pulled out of your comfort zone. What did you learn from that experience?
In your opinion, what is a challenge currently facing our region? What solutions do you have to solve this challenge?
Why do you want to participate in Regional Youth Leadership?
Other
PARENT/GUARDIAN PERMISSION
I have read the information on Regional Youth Leadership and am willing to have my child participate. I understand it is my
responsibility to provide transportation for my child to and from the sessions with the exception of the retreat. A bus will be provided
to transport students to the retreat site. In the event that transportation is required during a session, Regional Youth Leadership, its
agents, and its employees have my full permission and consent to transport my child by public school bus, private automobile, vans or
other appropriate means of transportation.
I hereby release and hold harmless Regional Youth Leadership, its members, its agents, employees or any individuals involved in
planning, organizing or presenting programs, for any accident, injury, illness or any damage whatsoever related to the above-mentioned
student’s attendance at or participation in any activity or session of Regional Youth Leadership.
I hereby grant Regional Youth Leadership permission to photograph my child and to publish the photos in connection with the
advertisement of RYL including without limitation brochures, portfolios, flyers, catalogues, compact discs, and websites.
Print Name of Parents/Legal Guardians
Signature of Parent/Legal Guardian
Home Phone: (
)
Email:
Date:
Work Phone: (
)
Cell Phone: (
)
(We will send monthly session reminders to you at this email address)
Emergency Contact:
Emergency
Contact Phone:
(when parent cannot be reached)
(
)
SCHOOL PERMISSION
All applicants MUST have the approval of their school principal to attend sessions of Regional Youth Leadership. Please have your
principal sign below.
I approve the
participation of
in Regional Youth Leadership for the
2015/2016 school year.
Student Name
Principal Name:
Principal Signature:
Date:
$100 Participation Fee Attached
Please invoice us for $100 Participation Fee
School Contact Information
School:
School Phone:
School Contact:
(
)
School Contact Email
ATTENDANCE
If selected, you commit to attend the program orientation, the opening retreat, each one of the seven program sessions and graduation. Full
attendance by each participant is essential if Regional Youth Leadership is to meet its objectives. Regional Youth Leadership will work with
schools to encourage school attendance credit. I understand and accept the attendance requirements for Regional Youth Leadership.
Student Signature:
Date:
Please print application and obtain all signatures before mailing.