High School Interest Form// Formulario de interés de la escuela secundaria

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Thank you for your interest in the Girls A.C.T program; if you are looking to join our monthly meetings at our Patchogue office please this link:

If you are interested in opening a Girls A.C.T chapter in your school, please answer all questions below.

Gracias por su interés en el programa Girls A.C.T; Si desea unirse a nuestras reuniones mensuales en nuestra oficina de Patchogue, visite este enlace: Si está interesado en abrir un sede de Girls A.C.T en su escuela, responda todas las preguntas a continuación.

What is your full name?

What is the best phone number to contact you at?

What is the best email address to contact you at?

What High School are you interested in bringing Girls A.C.T to?

What is your relationship to this high school?

Student at high school

Parent of a child who attends school

Guidance counselor at the school

Principal or higher administration at the school

Teacher at the school

other

Clear selection

Why do you want to bring Girls A.C.T to this school?

Submit

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