changeenterprises.org
Home
ABOUT C.H.A.N.G.E.
THE C.H.A.N.G.E MANTRA
Founders' Passion
Programs
Volunteer
Contact Us/inquiries
Home
ABOUT C.H.A.N.G.E.
THE C.H.A.N.G.E MANTRA
Founders' Passion
Programs
Volunteer
Contact Us/inquiries
Entrepreneurship Workshop Application (July 18-19, 2013)--Alexandria, Va
*
Indicates required field
Student's Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Current School
*
Current Grade (Grade for 2012-2013 School Year)
*
Age
*
Parent/Guardian Information
Parent's Name
*
Parent's Phone Number
*
Parent's Email
*
If you do not have an e-mail address, please input the following: noemail@address.org
Please list other activities student is involved in:
*
Does the student have transportation to camp?
*
Yes
No
What is the best way to reach you?
*
E-mail
Phone
Text
Check the Best Option
Is financial aid required for your student to participate?
*
Yes
No
If Financial Aid is needed, contact the Workshop Directors immediately. Dr. Jametta Davis at 703-899-0482 or Shavonta Green-Floyd at 703-798-6303.
Adult Recommendation
(Family Member, Family Friend, Community Leader, etc)
Name
*
Adult Recommendation can be a Family Member, Community Leader, etc.
Position/Relationship to student
*
Why do you recommend this student for this program?
*
Does the student display any behavioral issues that might interfere with working in a team environment during the workshop?
*
No
Yes, Please Explain Below
Please explain any behavioral issues here.
*
What are some focus areas that woud benefit this student?
*
All Applicants Must Complete This Section
My goals are:
*
List your hopes, dreams, desires, or even your summer or academic goals. We just want to know more about you!
I'm interested in
*
Arts (of Any Kind)
Computers/Technology
Fashion
Science
Sports
My other areas of interest are:
*
Please rank your areas of interest listed above from 1 to 5
*
1 being most interested and 5 being least interested in.
Please tell us about yourself and why you are interested in the Girls Run the World Summer Entrepreneurship Workshop.
*
We want to know more about you so we can tailor the workshop, so come on tell us a little about YOU!
Applications can be submitted by pressing the button below, if you make an error or need to amend the application, please e-mail us at
change1enterprises@gmail.com
or contact the NoVa Workshop Directors (information below).
If you need financial assistance contact the NoVa Workhop Directors (information below).
Workshop Directors:
Jametta Davis, 703-899-0482, jamettadavis@changeenterprises.org
Shavonta Green-Floyd, 703-798-6303,
sgfloyd@changeenterprises.org
Submit
