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This survey will help G.E.M. understand the dynamic of your school/entity

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* 1. Please write first and last name of person filling out this form

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* 2. Please write your email address

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* 3. Please write the name of the school/entity that will host the G.E.M. Program

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* 4. Please write the best phone number to contact you 

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* 5. Please share the number of girls who will be in your G.E.Ms Gather Group Chapter

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* 6. Please select the grade level for the girls in your G.E.M.s Gather Group

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* 7. Please select all that apply: Share the ethnic demographic of the girls you will be serving

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* 8. Please select the average grade point average for the girls participating in the G.E.M.'s Gather Group

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* 9. Are any of the G.E.M participants At-Hope Youth

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* 10. What is the average of the school attendance rate for the G.E.M. participants

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* 11. Please select the types of discipline or behavior concerns the G.E.M. participants exhibit 

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* 12. Please select the social and emotional concerns the G.E.M. participants are often seen for

0 of 12 answered
 

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