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DreamGirls Program Interest
Please fill out the survey completely, so that we can better serve you. We will notify you by email regarding how you can participate or bring an event to your community!
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* Indicates required question
Parent email
*
Your answer
Daughter's age
*
11
12
13
14
Other:
Zip Code
*
Your answer
Program interested in (select multiple if applicable)
*
Virtual Dream Day
Coding with Verizon (documentation of community need required)
Beverage Development with Coca Cola
I am interested in more information about leading a group in my community (teacher, Girl Scout leader, etc) or contacting my school district regarding hosting an event.
*
Yes
No
Required
My daughter has attended a DreamGirls event before
*
Yes
No
I am a Phi Sigma Rho Alumna
Yes
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