"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 $590 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 30 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 314-963-1321. Thank you for your interest in our programs. We look forward to receiving your application.

Applicant Information

Please complete the following information about yourself.

Applicant First Name *

Enter your first name

Applicant Last Name *

Enter your last name

Applicant Birthdate *

Enter your birthdate in format mm/dd/yyyy

Applicant Grade *

Enter your 1-2 digit grade in school for the current or most recently completed year; for post-high school, enter 13

Applicant Address1 *

Enter your street address

Applicant Address2

Enter additional address line

Applicant City *

Enter your city

Applicant State

Choose your state (US)

Applicant Province

Choose your province (Canada)

Applicant Country *

Choose your country

Applicant Postal Code *

Enter your postal or zip code

Applicant Phone Number *

Enter your full phone number, including area code

Applicant Email Address

Enter your Email address

Organization Information

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

Date Award Received *

Enter date you received your "I Dare You" award

Organization Name *

Enter the name of the organization

Organization County *

Enter organization county

Organization Address1 *

Enter organization street address

Organization Address2

Enter additional address line

Organization City *

Enter organization city

Organization State

Choose the organization state (US)

Organization Province

Choose the organization province (Canada)

Organization Country *

Choose the organization country

Organization Postal Code *

Enter organization postal or zip code

Contact Name *

Enter the full name of the organization contact

Contact Phone *

Enter the contact phone number

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 *

Captcha

Please enter the characters you see in this picture:

Characters

This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen.
Can't see the image? Click here for an audible version in English.

Need assistance with this form?