I understand should I be selected to receive an award I will be required to sign a media consent form allowing information about me including my name, call sign, a short biography and submit a head shot photo for inclusion in the YL Harmonics magazine and on the YLRL website. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. Response Required for questions with an *.
In the event of multiple submissions by the same person, only the last submitted form will be reviewed for scholarship purposes.