Cora Garner
Girls Leadership
111 Myrtle St., Suite 101
Oakland, CA 94607
Fax: 410-558-6673
cora@girlsleadership.org
girlsleadership.org
SUMMER PROGRAM PARENT/GUARDIAN & GIRL
APPLICATION PART II: NEW APPLICANTS
Girl applicant’s name: _____________________________________
Current grade: ______
Parent/Guardian name: ____________________________________________
Parent/Guardian relationship to the applicant: __________________________
Parent/Guardian email: ________________________________
TO THE PARENT/GUARDIAN:
We are so excited that you are interested in the Girls Leadership Summer Program!
Please feel free to type directly into this open MS Word document, or print it, and fill
it out by hand. If filling out by hand, please create more space for your answers
between each question.
1. What prior residential program experience does your girl have? How long and
how many times has she been away from home?
2. How does your girl manage with living away from home? What tips and
information should we be aware of in regards to this?
3. What changes, if any, have you seen in your girl as a result of her being away
from home?
4. What medical, physical, emotional or other conditions would limit her ability to
participate in vigorous activities such as a ropes course or sports & fitness, if
any?
5. What learning differences or classroom needs does your girl have, if any?
6. What dietary restrictions does your girl have, if any?
7. Please feel free to describe additional information about your girl (Related to
school, family, friends, and including any recent life events).
8. Does your girl know any other girls applying to our program?
9. If yes, please list their name(s):
10. Has your girl ever needed the support of a psychologist or psychiatrist, or is
she currently in therapy?
11. What medications are your girl currently taking and for which conditions, if
any?
12. Girls go without electronics during our program, except for phone time once
during their stay. Do you foresee any challenges to this policy for you or your
girl?
Thank you for completing the first part of the application. The next portion is for your
girl to complete. We request that you let her complete the questions on her own.
TO THE GIRL APPLICANT:
We are so excited that you’re interested in Girls Leadership! We want to make this
the best possible experience for you and the other girls in the program. We're asking
the questions below to get to know you better. We’re not checking how you spell or
write. We do want you to complete the questions below without help from an adult.
We really only want to hear from you. There aren't any "right" or "wrong" answers;
just be yourself and let us know who you are. Thank you!
1. List five adjectives that you would use to describe yourself (for example:
cheerful, silly, etc.)
2. What about your school do you like? What do you find challenging?
3. If you had a free day and you could do anything you wanted, what would be
the top three things that you would want to do?
4. What did you do last summer?
5. How would you describe your friendships?
6. How do you feel about being in a residential, three week long (9 nights & 10
days for grade 6) summer program?
7. What is the longest you’ve been away from home without your parents or
guardians? What did you do?
8. How do you feel about being in an all-girl program?
9. Tell us something that you’ve done that you are proud of.
10. You will go without electronics during our program, except for phone time
once during your stay. Do you see any challenges with this policy for you?
GIRLS RISING INTO GRADES 7-12 ONLY:
(If you are a rising 6th grade girl, you have the option to answer the 4 questions
below.)
1. Imagine yourself 10 years from now. What do you see yourself doing?
2. GL is made up of girls from very diverse backgrounds. How do you feel about
being in this type of program?
3. What does a leader look like to you?
4. Why do you want to be a part of the GL Summer Program?
Once both the Parent/Guardian and Girl portions of this application are complete
please email, snail mail, or fax these application pages back to us. This will complete
Application Part II.