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The Inspi(Her) Summit Participant Application
First Name *
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Last Name *
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Email
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Home Phone
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Cell Phone *
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Address *
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City (Must Include) *
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Age *
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Birthday *
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School Name
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School Level
What grade are you in?
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What is your Gift? *
Explain your talent
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How did you hear about Girls With Gifts, Inc? *
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What is your race?
Do you participate with any other programs or organizations to help develop your gifts and talents? Yes or No?
If yes, please list name of programs:
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Why do you want to attend the Summit?
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If an interview is needed, how would you share your "Gift" with Girls With Gifts, Inc.?
Example: showcase of your talent through video, photos, live demonstration
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Parent/Guardian Full Name *
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Parent/Guardian Email
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Parent/Guardian Cell #
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Parent/Guardian Address
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Relationship to Applicant
Emergency Contact Full Name *
**In the event that a parent/guardian cannot be reached, please list person(s) to contact in case of an emergency**
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Emergency Contact Phone Number *
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Relationship to applicant *
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Parent/Guardian Electronic Signature
Typed signature is fine
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