Girls Inc. - Will Power/Won't Power Program Application

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Girls Inc. - Will Power/Won't Power Program Application - Fall 2023

Dear Parents & Guardians!

Thank you for your interest in enrolling your daughter in Girls Inc!

We are excited for a new year and a new start soon! Below please find more information on the program for 8th graders as well as program information:

*The Will Power/Won’t Power® program is a series of interactive assertive communication workshops for participants ages 12-14. The program focuses on values and healthy relationships, helps participants identify and avoid risky situations, provides factual information on female health, and encourages our group to value and support each other.

*The Will Power/Won’t Power® program has a total of 8-10 sessions. We will meet once a week afterschool and hope to be able to work with your daughter in this program, and have your support. Please complete the following application to enroll your daughter in the program.

Program is being offered at the following sites*:

- Harden Middle School, Salinas
- Washington Middle School, Salinas
- NMC Middle School, Castroville
- Seaside Middle School, Seaside
- Main St. Middle School, Soledad
- Vista Verde Middle School, Greenfield
- Chalone Peaks Middle School, King City
- Rancho San Justo Middle School, Hollister
- Rolling Hills Middle School, Watsonville

*The sites you see listed are sites where programs are set to be hosted, but does not mean all girls will be from that school. If you are interested in joining the program, but your school does not appear, please look for the closest site to you.

Program will begin in the fall, September 2023, once a week afterschool.

Once you submit your application we will be in contact you with more details about dates and sites as soon as we have the details.

If you have any questions of need more information please contact Lupita at: gbravo@girlsinccc.org or contact the Girls Inc. office at 831-772-0882.

Please provide your name and best contact number where we can reach you.

Participant's Last Name: *

Participant's First Name: *

Middle Name:

Best Contact E-mail for Participant:

Mailing Address: *

Apartment Number: *

City: *

State: *

California

Other:

Zip Code: *

Home Phone Number: *

Cell Phone: *

School you attend: *

Shirt Size: *

Which school would you like to attend the program at? *

Harden Middle School, Salinas

Washington Middle School, Salinas

NMC Middle School, Castroville

Seaside Middle School, Seaside

Main St. Middle School, Soledad

Vista Verde Middle School, Greenfield

Chalone Peaks Middle School, King City

Rancho San Justo Middle School, Hollister

Rolling Hills Middle School, Watsonville

Grade: *

Birthdate: *

Age: *

Ethnic Group:

Hispanic

Not Hispanic

Clear selection

Race:

White

African American

Asian/Pacific Islander

American Indian

Multiracial

Other:

Clear selection

Annual Household Income:

Under $10,000

$10,001-$20,000

$20,001-$30,000

$30,001-$50,000

Over $50,001

Clear selection

Do you Receive Free or Reduced Lunch at School:

Yes

Clear selection

Number of Family Members Living in Household:

Family Type:

Two Parents

Mother Only

Father Only

Relatives(not parents)

Parent & Step Parent

Foster Parents

Other:

Clear selection

Primary Language Spoken at Home:

English Only

Spanish Only

English & Spanish

Other:

Clear selection

Parents' Name: Mother's Full Name:

Mother's Best Contact Phone Number:

Father's Full Name:

Father's Best Contact Phone Number:

Best Contact E-mail for Parent: *

How did you hear about this program?

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