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SUPERGirls SHINE Club Application (Park View Intermediate)
Email address *
SUPERGirls SHINE Foundation (SGSF)
MISSION: To engage, empower and develop tweens, teens and young ladies into impactful game changers through character development and leadership with a focus on science, technology, engineering and mathematics (STEM).

VISION: Through its partnership with girls, parents, educators, volunteers, community leaders, donors, and strategic alliances commits to providing mentorship, bridging the gap in communication and creating unique opportunities for self-awareness activities, career preparation, community engagement, financial responsibility and educational planning.

Core Values …
SUPERGirls have voices
Generational learning & wealth
Respect for all
One Global Network

WELCOME Girls! We're excited that you are interested in being a part of your schools's SUPERGirls SHINE Club. If accepted, your experience will engage, develop, empower and expose you to life-long lessons in leadership, character building with a focus on STEM. Please complete and return no later than Monday, November 13, 2017.

Is English the first language you speak at home? *
Among my friends, I speak mostly as a language ... *
What is your full name? *
What is your cell number? *
What is your birth date? *
What school do you attend? *
What course schedule do you participate in? *
When you are in a group setting, what do like about it and what do you not like about it?
What size t-shirt do you wear and indicate is this an adult size or youth size?
Are you on Social Media? *
If yes, what Social Media Outlets do you use? Name them all.
List here the name of your Social Media Page and your handle for each page.
What are three things you want to accomplish this school year? *
What are your strongest subject areas? *
If you had a chance to meet a professional in STEM (science, technology, engineering or mathematics), what job, industry or company would this person work for and why?
Is STEM (science, technology. engineering and mathematics) interesting to you? If so, why?
When not in school, what do you like to do and why?
What qualities do you look for when becoming friends with a person, male or female?
When you have difficulty in school, with a friend or even your parents, how do you handle getting through the tough moment or time? (Please be specific)
Would you say, academically, you are (a)an ...
Please share with us a little about you in your own words.
This summer, if you had a chance to attend a STEM camp or summer shadowing program with a professional in STEM, which would you choose and why?
If chosen, what do want to learn or experience in your SUPERGirls SHINE Club?
Who's your SHEro/Hero and why?
Describe a typical day for you in school.
What do you like to do when no one is around?
If you had to speak in front of a group of your peers, what would you share with them and why?
If an athlete, what sport do you play and position?
What does being a SUPERGirl in STEM mean to you? *
In your opinion, what is a leader?
Do you consider yourself a leader? Yes or No. If yes, explain how. If no, explain why not now. *
Please share your thoughts. A group of friends were selected to represent your school for a STEM Day at a local university. You've been friends since the 4th grade so you pretty much know each other's quirks, likes and dislikes even your strengths and weaknesses. How would you propose to your Club advisor which 3 of the 7 girls should represent your Club and have lunch with the president of the university? *
If chosen, how will this Club experience help you reach future goals? *
Emergency Contact Name? *
Emergency Contact Number? *
Emergency Contact Relationship? *
Statement of Waiver - By completing this form and marking the "YES" button, I understand that I am voluntarily applying for the 2017 SUPERGirls SHINE Club. I understand that I have to meet full requirements and uphold rules, code of conduct and expectations set forth by my school, administrators, teachers and SUPERGirls SHINE Club TEAM. *
Your parent/guardian is a valuable asset to your success in your SUPERGirls SHINE Club experience. Please be sure to share with him/her that you have applied and we will reach out to them with further questions. Click "YES" indicating you have shared this application with them. *
Parental/Guardian participation is a requirement in order for you to remain in good standing with your SUPERGirls SHINE Club experience. Please note, a parent/guardian is required to volunteer at least 25 hours throughout the course of the year. Please click ... *
Parent(s)/Guardian(s), if your daughter is selected, you and your daughter is required to attend a mandatory meeting, Thursday, Jan 11, 2018 at 5pm CST. *
If you desire to keep a copy for your records. Please select PRINT on your browser menu bar prior to selecting DONE to keep a record of this questionnaire. Thank you for completing this questionnaire.
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