Start a IYL Qabeela in Your Community

Start a IYL Qabeela in Your Community
Qabeela Amir or Amira Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth (Must be 21 or Older)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current Occupation
List Any Additional Adults Who Will Help Lead Your Local Qabeela

Please provide the full name, email address, phone number, and physical address of each adult who will be involved.

We recommend having at least one male and one female adult leader (Amir and Amirat) in each Qabeela to provide appropriate mentorship and support for both young men and young women.
List Name, Email, Phone and Address of All Other Adults Involved. Leave Blank if No One Else is Involved.
Where Would You Like to Establish Your Qabeela?
City/Community
Will your Qabeela be affiliated with an organization? If no affiliation, choose "Independent"
If affiliated, what is the organization's name?
How many students do you anticipate recruiting?
What age group will your Qabeela serve?
When would you like to launch?
Have you previously worked with children or teenagers?
Why are you interested in starting an IYL Qabeela?
Training and Responsibilities
Applicant Confirmation
Should be Empty: