Girls in the Know Scholarship Application
Speaker Series Location
Today's date
MM
/
DD
/
YYYY
Mom/Caregiver First & Last Name
Your answer
Daughter/Girl First & Last Name
Your answer
Girls Age
Your answer
Girls Birthdate
MM
/
DD
/
YYYY
Mom/Caregiver Street Address
Your answer
City, State, Zip
Your answer
Mobile Phone Number
Your answer
Email Address
Your answer
Have you ever been convicted of a felony?
How did you hear about the program
Your answer
Specify the location (school name) you wish to attend
Your answer
Please indicate the amount you are able to contribute
note: we receive a high volume of applications and will do our very best to accommodate your request
Your answer
I certify that my answers are true and complete to the best of my knowledge.
Please check box below in lieu of signature
In 2-3 sentences, please provide an explanation of your financial need and provide examples of how the program will benefit you and the girl attending?
Your answer
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