Student Information Form 2021-2022
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Name: (First & Last) *
Are you signing up to be a part of Girls Taking Action or Boys of Hope program? *
How did you hear about the program? *
Phone #: *
Email: *
Parent Name: *
Parent Email: *
Parent Phone #: *
School: *
Student ID #: *
Grade: *
Are you a graduating senior? *
If so, have you applied for college? *
If known, where will you be attending college?
Are you on social media? If so, what social media app do you use the most? *
Thank you for your interest in our program! We'd love to introduce ourselves and hear about your hopes for the program year.  What is a good time to set up a phone interview this week? *
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T-Shirt Size: *
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