Application

Please Read Carefully

Thank you for applying for a GirlVentures Program. This application only needs to be filled in once during your participation with GirlVentures.

This online application is going to ask a wide range of questions about the participant, the participant’s family, and home.  It is important to answer all questions, as much of our funding is from sources that require us to share statistics about the populations we serve.  Also, the more we know about our applicants and participants, the better our programs can be. All information is 100% confidential.

There are 4 parts to the application.  It will take about 10 minutes to fill in.

1. Part 1 – Participant and Family Information
2. Part 2 – Parent/Guardian Information
3. Part 3 – Additional Household Information and Course Specific Information
4. Part 4 – Application Fees
   

Before applying, please read our policies. Thank you!

>> Step 1 of 4 - Applicant & Family Information

Girl's Name	First Last
Girl's Address	Street City State/Province Zip
Girl's Phone	Home Cell (optional)
Girl's Email	(optional - we like to involve her in the process!)
Girl's Age	Birthdate (to determine program eligibility) Grade Select One 6 7 8 9 10 11 12 College School
Girl's Shoe Size	Select One 3 3.5 4 4.5 5 5.5 6 6.5 7 7.5 8 8.5 9 9.5 10 10.5 11 11.5 12 12.5 13 13.5 14 14.5 15 15.5 (because we provide climbing shoes)
Girl's Body Size	Height Weight (so we can select the right pack size for her)
Girl's Primary Language	Select One Cantonese English French German Spanish Vietnamese Japanese Korean Mandarin Persian Portugese Russian Tagalog Portuguese
Girl's Race/Ethnicity	Select One Asian Pacific Islander Black/African American Hispanic Latina Middle Eastern Native American/Indian White/Caucasian Multiethnic Other (our funders require we report this in who we're serving)
Household Income	Select One 30,000 and below 31,000 - 50,000 51,000 - 75,000 76,000 - 100,000 100,000 and above Type --None-- Single Double Multi
Do you plan to apply for Financial Aid?	No Yes
How did you hear About GirlVentures?	--None-- GirlVentures Website Flyer Friend or Family (specify) Healthy School Teams Organization (specify) Other (specify) Presentation(specify) Board Challenge Newsletter Volunteer Center Website Teacher or school faculty member(specify) Other website (specify) Therapist Please specify
Parent/Guardian Full Name