2025 Alfalfa Electric Co-op Youth Tour Application

2025 Alfalfa Electric Co-op Youth Tour Application

Youth Tour - June 13-19, 2025 CYLC - July 11-17, 2025 Leadership Summit March 17, 2025
DEADLINE: THURSDAY, JANUARY 24, 2025

Applications submitted after midnight on January 24 will NOT be accepted.

Please fill this application out in full.
Is your family an Alfalfa Electric Cooperative member?

YesNo
Student Name

First NameLast Name
Student Email
example@example.com
Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone Number
Please enter a valid phone number.
Student Gender

MaleFemale
Student School:
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Teacher/Counselor Name

First NameLast Name
Teacher/Counselor Email
example@example.com

I CONFIRM I am able to attend the 2025 Youth Tour on June 13-19, 2025, CYLC on July 11-17, 2025 and Leadership Summit on March 17, 2025. I understand that if I win the contest and forfeit the trip that I may be required to refund my sponsoring cooperative the $500 scholarship and all or some of the cost of the trip.
Student Signature

Clear
Should be Empty:

Student Video