Girl Ventures
Information for recent and long time Alumnae!
Resources: Partner Organizations and More!
Contact Kay and Directions
 

Registration Form

Go Back to Programs

Submission of this form indicates that you and your family have discussed the course for which you are applying.

Course Information:

Which course are you applying for?
What are the course dates?

 

STUDENT INFORMATION:

Name: Phone Number:
Street Address: Email Address:
City, State: Zip Code:
Birth Date: Shoe Size :
Ethnicity (Optional): Grade level:
Would you like to request tuition assistance? Middle School:

PARENT/GUARDIAN INFORMATION:

Parent/Guardian 1:
Address:
Occupation:
Employer:
Phone (home):
Phone (work):
Cell/Pager:
Email:
Best Way to Contact Me:    

My initials below indicate a genuine desire to participate in this GirlVentures course
and an understanding of its challenging nature. I have read and accepted the terms
of payment and the terms of the refund policy.

Applicant Initials:
Date:
Parent/Guardian Initials:
Date: