Girls Inc. Afterschool Program
Program Details
Program Starts November 12th, 2020
Thursdays & Fridays 3:30PM - 4:30PM

Girls Inc. of Carpinteria is providing a virtual programming experience through which Girls Inc. staff will facilitate program activities through an online platform. Girls Inc. of Carpinteria will use an application provided by the Santa Paula Unified School District called Google Classroom. Please refer to your digital use requirements provided by SPUSD. Reach out to me with any questions at yvelasco@spunifiedsd.org
I give permission for my daughter/s to participate in online (virtual) programming in partnership with Girls Inc. and SPUSD. *
Required
Child Name *
Child's Date of Birth *
Child's School
Child's Grade as of August 2020
Girls Inc. of Carpinteria Census Report 2020-2021
This information is kept anonymously and in confidence. It will be used strictly for statistical data reports to the Girls Inc. National.
Number in Household (adults and children):
Child's Ethnicity
Primary Language
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Family Configuration
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Income Category
Child Qualifies for
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Please select the highest of education
Less than high school
High School diploma / GED
Some college
2 year college
Bachlelor's Degree
Master's Degree
Doctoral Degree
Professional Degree
Don't Know or N/A
Mother
Father
Clear selection
Is any member of immediate family active duty military personnel?
Clear selection
Is your child an English Learner?
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Does your child have an IEP?
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Contact Information
Please fill out your contact information
Parent / Guardian Name *
Parent / Guardian Phone Number *
Parent / Guardian Email Address
Student's Santa Paula Unified School District Email (Meeting invites/updates will be sent to this email) *
Home Address *
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