Student's Ethnicity (Please check all that apply): *
Required
Does the student qualify for free or reduced lunch? *
Student's T-Shirt Size: (Pick Adult or Youth and Size): *
Required
Please check all that apply to your student: *
Required
School Attending: *
Your answer
What do you do for fun when you're not studying or performing community service? *
Your answer
What is a novel or book that you've read for pleasure recently and liked, and why did you like it? *
Your answer
Describe a school-related problem you had to face recently. What steps did you use to deal with it and what were the results? *
Your answer
How do you plan to maximize your experience with Girls Heart Reading Ohio? And how will this program contribute to your future goals? *
Your answer
Is there anything else you would like us to know? *
Your answer
Parent's Name: *
Your answer
Parent's Phone Number: *
Your answer
Parent's E-mail: *
Your answer
Parent's Mailing Address: *
Your answer
Parent: What is the highest degree or level of education you have completed? If currently enrolled, highest degree received. *
Before you submit your application check that all the steps below are complete. *
Required
How will you be making your program fee payment? (Fundraising opportunity is available if needed. Please call Maritza, after completing the application at (614) 516-5555). *
Write your full names (student and parent) and today's date below to confirm that you understand and have read this program overview in it's entirety. *
Your answer
Thank you and we look forward to reviewing your student's application!