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Print and complete application form and return to: Girls Learn International, Inc. For more in-depth replies to some questions, please use extra sheets of paper.
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| I. Basic Information | |
I am:
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Your email address: |
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| Name of School: |
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| Street Address: |
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| City:
State:
Zip:
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| Email Address: |
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| Best way to communicate: |
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| How did you learn about the program? |
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| Name of Principal or Other Contact Person in Faculty or Administration | |
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| Telephone Number: |
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| Email Address: |
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| What is the Best Way To Communicate With the Contact Person? | |
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| Name of Chapter Facilitator, If Different (Note that each Chapter is required to have an advisor from the faculty or administration of the school) | |
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| Telephone Number: |
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| Email Address: |
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| What is the Best Way to Communicate With the Advisor? | |
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| Are You Interested In Working With a Facilitator From the Girls Learn International College Leadership Division, if available?
Yes
No |
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| II. Chapter Information | |
Is your school: |
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| Is your school: |
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| Is your school: |
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| How Many Students Are Enrolled in Your School?
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| Will the Girls Learn International Chapter Be Open to All Students?
Yes
No |
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| If no, please explain | |
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| Will the Girls Learn International Chapter Be Organized As | |
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| Does Your School Require Students to Participate In Community Service? | |
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Yes
No |
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| If yes, how many community service hours are required per year? | |
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| Will Your School Provide Community Service Credit for Participation In Girls Learn International?
Yes
No |
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| If so, how many hours?
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| Describe Other Club and Community Service Activities in Your School | |
Additional Comments or Questions |
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