Strong, Smart & Bold Learning Academy Registration Form
Summer + Girls Inc= Girl Power! Our Strong, Smart & Bold Learning Academy offers a variety of fun and educational virtual workshops for girls entering 5th-9th grades. For full descriptions of our workshops, please go to the Pelham Public Library website. Girls Inc of Central Alabama is proud to partner with the Pelham Public Library to offer our unique pro-girl programming. We equip girls to be confident, navigate gender, economic, and social barriers, and grow up healthy, educated, and independent.

Dates of our program: June 22-26, 2020 and July 6th-10th, 2020
Deadline to register: Wednesday, June 17th

Got questions about the Strong, Smart & Bold Learning Academy? Contact: Julean Kirkpatrick, M.A., Community Impact Program Manager, jkirkpatrick@girlsinccentral-al.org, or 205-599-5554. For more information about Girls Incorporated, go to: https://www.girlsinccentral-al.org/ or view our video: https://www.youtube.com/watch?v=T-KOqZt1yF0

The registration information requested is for grant purposes only and is confidential. One to two girls can be registered with this form.
Email address *
Parent or Guardian Name *
Phone number
Name of Girl (First and Last Name) *
Girl's Age *
Girl's date of birth (month/day/year) *
Girl's Grade (grade she is going to in the Fall) *
Girl's Race (This information is confidential)
Clear selection
Who does she live with most of the time? (This information is confidential)
Clear selection
Class Registration (Check all workshops that you are interested in attending virtually!) *
Required
Name of Second Girl (First and Last Name)
Girl's Age
Clear selection
Girl's date of birth (month/day/year)
Girl's Grade
Clear selection
Girl's Race
Clear selection
Who does she live with most of the time?
Clear selection
Class Registration (Check all workshops that you are interested in attending virtually!) *
Required
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