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G.I.R.L.s Interest Survey

The G.I.R.Ls Leadership Program is an all-girls program for ages 13-18 with a focus on self-esteem, self-awareness, college and career development, leadership, social justice issues, and many other topics dedicated to empowering young ladies. If this sounds like something you are interested in, please fill out the survey below. ALL sessions will be held at The Ready Center Located at 1916 Vel R Phillips Ave, Milwaukee WI 53212.  For additional questions contact LaQuita Grinnage-Program Manager of Leadership & Service by phone at 414-940-2489 or by email at laquita.grinnage@bgcmilwaukee.org

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* 1. Youth Name (First and Last name)

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* 2. What is your email address?

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* 3. What is the cellular phone number?

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* 4. What are two words to describe your character?

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* 5. Address (Include City, State, and Zip Code) 

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* 6. When is your Birthday? 

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* 7. What School do you attend or will be attending in the fall 2022?

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* 8. Parent/Guardian Name(First and Last Name) 

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* 9. Parent/Guardian Address (Include City, State, and Zip Code) 

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* 10. Parent/Guardian Phone Number 

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* 11. Parent/Guardian Email Address 

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* 12. What are some topics of interest for you, or what questions do you have about the program?

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* 13. Are you interested in additional Leadership & Service Programs?

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