Registration
Thank you for your interest in Girls Lobby! We look forward to taking power and giving back with you this legislative session.

Program: Girls Lobby's 2021 Legislative Program runs for eight weeks during late January to Mid-March.

You will be required to attend weekly Cohort Meetings. Weekly Cohort Meetings will take place over Zoom, a video-chat platform that will serve as our electronic classroom. You will attend either Tuesday, Wednesday, or Thursday evening meetings from 7-8pm throughout the course of the program. You will indicate which evening you will consistently attend throughout the program on the form below; once input, this information is final.

You will be required to attend two Saturday events as part of the Girls Lobby program. Events will be virtual unless otherwise noted. One event will take place in early January and the other in early March.

Cost: The registration fee is $20. A check may be mailed to P.O. Box 1082 in Provo, UT 84603. You may also pay by completing your payment through this form via PayPal. If you would like to request a full scholarship, please email us at girlslobbyorg@gmail.com. If you have a refer-a-friend code, please enter it in the provided section.

Feel free to email girlslobbyorg@gmail.com if you have any further questions or concerns.
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Full Name *
Date of Birth (MM/DD/YY) *
MM
/
DD
/
YYYY
Email: *
Personal Cell: *
High School Name *
Mailing Address (So we can send you GL materials for the Opening Social) *
If you were referred to Girls Lobby by a friend, please write their name here:
T-Shirt Size *
Why are you interested in joining Girls Lobby? *
How did you hear about Girls Lobby?
Do you follow Girls Lobby on social media?
Clear selection
On which social media channels do you follow Girls Lobby?
Have you visited and/or purchased any Girls Lobby merchandise from our Redbubble store?
Clear selection
Which issues are you most interested in learning about this Legislative Session? *
Cohorts meet via a Zoom meeting from 7-8pm one night per week. Please indicate which days you are available to participate (you may select more than one, but you will only be placed in one cohort). *
Required
By typing my name below, I agree to attend all weekly Girls Lobby meetings on Zoom (a secure electronic classroom). I also consent to receive texts and emails from Girls Lobby. *
Name of Legal Guardian *
Email of Legal Guardian *
Cell Phone of Legal Guardian *
I understand that I, the legal parent or guardian of the above noted Girls Lobby participant, am solely responsible for my child's education. I have reviewed the curriculum in full and consent to their participation in the Girls Lobby program (and all that it entails: participation in anonymous surveys measuring impact, the creation of promotional videos, etc.) from January 1st to March 31st, 2021. My signature typed below certifies my understanding of and agreement with the above statements. *
Pay $20
If you have a scholarship or refer-a-friend code, you may skip this question and submit your registration. If you are from the Refugee Center, you may also skip this question. We will follow up with registrants to make sure each participant is properly registered. Pay at this link, then enter the receipt code below: https://paybyform.com/pay/8MNq24XUTOrrDqrJ
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