Full Name (required):

Age (required):

Birth Date (required):

Street Address (required):

City (required):

State (required):

Zip Code (required):

Your Best Phone (required):

Your Email (required):

Parent/Guardian Name (required):

His / Her / Their Best Phone (required):

His / Her / Their Email (required):

School in Fall (required):

Grade in Fall (required):

What neighborhood do you live in? (required):

Ethnicity:

Sexual Orientation:

Family Income Level:

How did you hear about the Summer Arts Apprenticeship? (please check all that apply)

FriendTeacher / CounselorFacebookFormer ParticipantYouth OrganizationOther

If Youth Organization, which one?

If Other, please list

GIRLFLY requires a full commitment of time and energy and a minimum of 80 hours. Can you commit to attending ALL the sessions?

YESNO

Is there anything that would prevent you from attending?

ESSAY QUESTIONS:
PLEASE ANSWER ALL of the questions, in three or four sentences each.

1. What is your experience in dance or performance?

2. What do you hope to gain from the Summer Arts & Activism Program?

3. What type of activism or issue are you interested in (i.e. immigration, education, health, community need, etc.)? Why is this issue important to you?

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