Smart Choices Program Application
Smart Choices is a week long summer camp program designed to help participants make positive life choices about school, relationships, and health! This program targets 8th & 9th graders.

Activities Include:

• Stay in the dorms on campus at a local university.

• Explore the university campus and get a feel for college life.

• Learn about college requirements and how to get a head start!

• Enjoying fun activities!

• Meet participants from other schools in Monterey, San Benito, & Santa Cruz Counties!

Program Location: UC Santa Cruz

Program Dates: June 21-25, 2022

Applications are due: Friday, June 3, 2022

Program Fee for the week: $100

Please complete the following information. For more information or an application please contact Girls Inc. at (831) 772-0882.
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Last Name: *
First Name: *
Middle Name:
Mailing Address: *
Apartment Number:
City: *
State: *
Zip Code: *
Phone Number: *
Participant's Email: *
Birthdate: *
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Mother's Full Name:
Father's Full Name:
Parent's Best Contact Email: *
Person to Contact in Case of Emergency: *
Relationship to Applicant: *
Emergency Contact Number: *
Ethnic Group:
(For statistical purposes only)
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Race:
(For statistical purposes only)
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Annual Household Income:
(For statistical purposes only)
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Number of Family Members Living in Household:
Family Type:
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Primary Language Spoken at Home:
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Middle School Attending: *
High School You Will Attend: *
Do you plan to go to college?
If yes please answer the next question.
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Are you involved in any other summer program? *
If yes, what program?
Are you planning to attend summer school?
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When do you start?
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How did you hear about Smart Choices?
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