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    RYPEN Application Forms

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    rotaractSH
    This document is a nomination form for the Rotary Youth Program of Enrichment (RYPEN) seminar taking place from September 9-11, 2011 in Old Mogo Town, NSW, Australia. It includes sections for nominee details, parent/guardian acceptance, and sponsorship by a local Rotary club. The form collects information such as the nominee's name, birthdate, contact details, interests, medical needs, and a photo. The parent section gives permission for medical care and lists the nominee's Medicare number. It requires signatures from the parent and a Rotary club representative.

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    RYPEN Application Forms

    Uploaded by

    rotaractSH
    101 views3 pages
    This document is a nomination form for the Rotary Youth Program of Enrichment (RYPEN) seminar taking place from September 9-11, 2011 in Old Mogo Town, NSW, Australia. It includes sections for nominee details, parent/guardian acceptance, and sponsorship by a local Rotary club. The form collects information such as the nominee's name, birthdate, contact details, interests, medical needs, and a photo. The parent section gives permission for medical care and lists the nominee's Medicare number. It requires signatures from the parent and a Rotary club representative.

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    This document is a nomination form for the Rotary Youth Program of Enrichment (RYPEN) seminar taking place from September 9-11, 2011 in Old Mogo Town, NSW, Australia. It includes sections for nominee details, parent/guardian acceptance, and sponsorship by a local Rotary club. The form collects information such as the nominee's name, birthdate, contact details, interests, medical needs, and a photo. The parent section gives permission for medical care and lists the nominee's Medicare number. It requires signatures from the parent and a Rotary club representative.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    101 views3 pages

    RYPEN Application Forms

    Uploaded by

    rotaractSH
    This document is a nomination form for the Rotary Youth Program of Enrichment (RYPEN) seminar taking place from September 9-11, 2011 in Old Mogo Town, NSW, Australia. It includes sections for nominee details, parent/guardian acceptance, and sponsorship by a local Rotary club. The form collects information such as the nominee's name, birthdate, contact details, interests, medical needs, and a photo. The parent section gives permission for medical care and lists the nominee's Medicare number. It requires signatures from the parent and a Rotary club representative.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    Rotary Youth Program of Enrichment Nomination Form Rotary District 9710, Australia

    Send completed form to Brian Wallace RYPEN Committee PO Box 889 NOWRA, NSW, 2541

    Members of the Rotary Club of support the nomination of the persons named below and their forms are attached. We accept responsibility for transporting the nominees to and from the Seminar 9th to 11th September 2011 Signed .. on behalf of the Club Nominees Name/s 1. 2.. Date of the RYPEN seminar: 9th to 11th September 2011 Venue: Old Mogo Town Mogo NSW Nominees Details (Please print clearly) Full Name (This will go on your certificate) Preferred Name or Nick Name for your name badge Birth date Sex M / F Home Phone Email.Fax Home or Postal Address. Suburb/Town.Post Code School Attending and Year Sport, Hobbies and Interests . Physical Disability. Any Special Dietary Requirements e.g. (Vegetarian) (Cant have wheat/sea food) . Please include a head and shoulders photo of yourself (normal size 10cm by 15cm)

    Rotary Youth Program of Enrichment Nomination Form Rotary District 9710, Australia
    PARENT/GARDIAN ACCEPTANCE This RYPEN Seminar is conducted and supervised Rotarians and their partners and Rotaractors, who live-in with participants. All have signed the Declaration for working with children, under the Child Protection Act 1998. Strict Rules will be enforced to ensure the safety and well-being of each participant. Accident Insurance has been taken out for the duration of Seminar. We do need your approval to seek medical assistance should an emergency occur. Please sign below to give your approval for you child to attend the RYPEN Seminar 9th to 11th September 2011 at Old Mogo Town. Applicants will not be accepted unless the Medicare Number is filled in. I give the RYPEN Committee permission to arrange Ambulance transport and medical attention for my son/daughter/ward if it is considered necessary. I expect to be notified as soon as practicable. Any special medication that has to be taken Medicare Number.. Signed Parent/Guardian Sponsoring Rotary Club Signed on behalf of Rotary Club.. Please include a head and shoulders photo of yourself (Normal size 10cm by 15cm)

    Rotary Youth Program of Enrichment Nomination Form Rotary District 9710, Australia

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