2019 Girls IMPACT Application
Girls IMPACT is an exciting Summer STEM Program for minority girls (rising 8th through rising 12th graders) held at Lawson State Community College in Birmingham, Alabama. This application should be completed by prospective Girls IMPACT participants. Scroll down to complete the application in its entirety. The application deadline has been extended to May 7, 2019.
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Name of School (please provide complete school name, including middle or high school) *
Your answer
Current Age *
Your answer
Birthdate *
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For the Fall 2019-20 academic year, I will be in the following grade level *
Current Grade Point Average
Your answer
Student's Phone Number *
Your answer
Name of Parent or Guardian *
Your answer
Phone number of Parent or Guardian *
Your answer
Email Address for contact upon acceptance into the program *
Your answer
Home Address - please include city, state, and zip *
Your answer
Girls IMPACT will meet 6 Thursdays during the summer (estimated time 10 am to 3 pm). Do you have the necessary transportation to participate in the program each week? *
The Girls IMPACT Program is set up as a math boot camp. Are you committed to working on math assignments at least 10 hours a week? *
The dates of the 2019 program are as follows: Which dates (if any) will you NOT be able to attend? (Note: Priority will be given to participants who can attend all sessions)
Will you be a first generation college student? A first generation college student is a student in which neither parent went to college. *
Does the Girls IMPACT staff have permission to use program photos (which may include you) for grant reports and marketing/promotional purposes? *
Required
Choose your adult t-shirt size. *
How did you find out about this program? *
Your answer
Essay: If you could be anything you wanted to be, what would you be and why?(150 words or less) *
Your answer
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