Winter/Spring 2019 Application for New Cool Girls
Registration for Cool Girls Science and Art Club is now open for Winter/Spring 2019!

The mission of Cool Girls Science and Art Club is to engage young girls in entrepreneurship, Science, Technology, Engineering, the Arts and Mathematics (e-STEAM) so they have the desire, confidence and skills to sustain their contributions to the community throughout their personal, academic and professional journeys. Cool Girls was co-founded and continues to be guided by elementary schoolgirls who are passionate about science and art.

This registration form is for both new and renewing Cool Girls entering grades 1-5.

The application is complete after you receive email confirmation of acceptance and payment arrangements have been made. No girl is turned away for financial reasons.

The form is long to help us best serve your daughter and your family. Please scroll down using the Tab button. THANKS!

If you have any difficulties with registration or need more information, please email Mary at coolgirls.scienceart@gmail.com, call 303 -931 -2280, or visit our website at http://coolgirls-scienceart.org/register.

About Your Daughter
Given name *
preferred name
Your answer
Surname *
Your answer
What is your daughter's date of birth? *
(MM/DD/YYYY)
Your answer
Languages *
(Please provide ALL languages)
Required
Home language *
(Select all that apply)
Required
Ethnicity *
(please include ALL ethnicities)
Your answer
Birthplace *
(City, state, country)
Your answer
School: *
Please fill in your daughter's school in "Other" if not listed.
Grade *
Your answer
Are you registering for the Tuesday or Thursday class? (Tuesday's Grades 1-3, Thursday's Grades 4-5) *
Teacher *
Your answer
Special interests *
(e.g., music, drawing, construction, animals, computers, robots, a specific science....)
Your answer
Entrepreneurship *
Has your daughter ever had a business (lemonade stand, pet walking, web design, etc.)? Please describe.
Your answer
*
Did your daughter participate in our 2016 Accelerator Camp at CU Leeds?
Contact Information and Other General Information
Primary contact *
(Last, First)
Your answer
Primary contact relation to child *
Primary contact mobile phone *
(xxx) xxx - xxxx
Your answer
Primary contact email *
Your answer
Street address *
Your answer
Home phone
(if applicable) (xxx) xxx - xxxx
Your answer
Name of secondary contact: *
(Last, First)
Your answer
Secondary contact relationship to your daughter *
Secondary contact mobile phone *
(xxx) xxx - xxxx
Your answer
Secondary contact email *
Your answer
Other person(s) authorized to pick up your daughter: *
(Please provide their first AND last names as well as their relationship to your child. If your child walks on her own to after-care at the school or elsewhere, please name the provider.)
Your answer
Siblings *
(Please give name, age and school for each)
Your answer
Siblings in Cool Girls *
If another daughter of yours has been or is in Cool Girls: *
(Please give their name(s) and grade(s) when they participated, including current returning applicant.)
Your answer
Referral *
Needs financial aid *
Confidential partial scholarships and installment plans are available. No one is turned away for financial reasons.
Allergies *
Please check all that apply.
Required
Please describe any medical conditions of which we should be aware. If there are none, please write "N/A". *
Your answer
Parent expectations *
(How would you like your child to benefit from Cool Girls?)
Your answer
Daughter's expectations *
(What does your daughter say she would like to experience in Cool Girls?)
Your answer
Volunteer
Cool Girls parents volunteer a minimum of 3 hours per semester--many much more. Your child loves it when you help her lead an activity; however there are other options at different times. And it can be lots of fun for you!
Volunteer choices *
Required
Parents', guardians' and family friends' special skills or facilities
(If you have a skill to share, or can arrange a tour of your workplace or in another way help Cool Girls learn about your profession, please note that here or in the Comments section below. Also, if your employer sponsors or donates to nonprofit educational programs, please provide its name so that we can contact the appropriate representative regarding mentors, materials or funds.) Thanks!
Your answer
Comments:
Please help us improve our programs with your testimonials, constructive criticism, and/or suggestions.
Your answer
May we use your comments in our outreach materials?
Agreement
* I agree to attend a meeting of parents and advisers to learn about how Cool Girls and I can help my child maintain and expand her participation in entrepreneurship, science, technology, engineering, the arts and math (e-STEAM) activities throughout her school years and career, if she so chooses.
* I will help her remember to bring her science notebook to each session and to write or draw in it outside of Cool Girls.
* I will regularly check the Cool Girls website at www.coolgirls-scienceart.org for updates on activities, scheduling, registration, field trips, etc.
* I give my child permission to participate in the Cool Girls after-school program and field trips, including to ride with volunteer drivers to and from field-trip sites if I am unavailable to drive myself and I have provided signed permission, printed or electronic, for that specific trip beforehand.
* I grant Cool Girls permission to include my child's unidentified photo and comments on its website and in other media.
* I understand that neither Cool Girls Science and Art Club, a 501(c)(3) nonprofit charitable organization, nor its leaders or other volunteers are responsible for any liability as a result of my child's participation.
* Regretfully, no refunds are available due to advance commitments for rent, supplies, etc. Cool Girls must turn away or wait-list other girls because of the demand for our program.
Parent or Guardian Electronic Signature: *
Please type your legal name.
Your answer
Date Signed: *
Your answer
Submit
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