MYA Participant Application

Form
Youth Participant Information
Youth Applicant's Full Legal Name as it appears on Passport or Birth Certificate*

First NameMiddle NameLast Name
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Citizenship*
Email*
example@example.com
As of October 1 of this year, what grade will you be in?
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Military Sponsor Information
Sponsor's Name*

First NameMiddle NameLast Name
Cell Phone Number*
Please enter a valid phone number.
Email*
Preferred Email Address
Sponsor Relationship to Participating Youth*
Is the military sponsor’s primary residence the same as the youth's primary residence?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Military Status*

M-DAY / DSGAGR / ADOS / TechnicianFormer / Retiree
Component*

Army National GuardAir National Guard
Date of Discharge

MonthDayYear
Date
Attach NGB 22 showing an Honorable Discharge from the Utah National Guard

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Commander's Information

RankFirst NameLast Name
Commander's Email
example@example.com
Commander's Phone Number
Please enter a valid phone number.
Will the Military Sponsor be the Primary Parent / Guardian for the two-week exchange?*

YesNo

Host Family / Home Information
What amenities will be available in your home for the Moroccan youth?

Single RoomShared RoomWi-Fi / InternetOther
Is the home the site of a functioning business?*

YesNo
Please list all pets in the home
List all individuals residing in the participating youth's home.

Include their name, gender, age, and relationship to the participating youth.
Name (First Last), Gender, Age, Relationship*
Photo of Youth and Family*

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Photo of Youth*

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Photo of the Front of Your House*

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Photo of the Inside of Your House*

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Release Forms

Please print, complete, sign, and upload these release forms.
You can also download the forms at http://bit.ly/4mlE4wP or by scanning the QR Code.
Rules and Standards of Conduct*

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Liability Waiver
Liability Waiver*

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Medical Release Form*

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Should be Empty:

Form