Caterpillar Girls Talk, USA 2020/21 Application                     ONLINE
for all young ladies ages 11-13
DREAMS Orgs. Inc email: dreamorgs@gmail.com
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Email *
WELCOME ❤️
Welcome to Girls Talk.USA.  The Caterpillar Troop is for young ladies ages 11-13.  

Who Referred you to DREAMS Orgs. Inc? *
MEMBERSHIP OPTIONS
Membership fees include:
1.DREAMS Student Manual "DREAMS... Don't Be Scared To Follow Them"!  Developing and Planning your DREAMS
2. Operation Fees.
Membership Dues *
Scholarship Needed: (Registration Fee will be $25) *
GIRLS TALK MISSION
DREAMS Girls are a sisterhood that provides valuable information on developing into womanhood while suppling them life changing resources to build a successful livelihood.

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CATERPILLAR BUTTERFLY GENERAL INFORMATION
PARTICIPANTS NAME (first & last) *
ADDRESS *
PHONE *
STUDENT EMAIL *
DATE OF BIRTH *
MM
/
DD
/
YYYY
AGE *
NUMBER OF YEARS IN DREAMS *
NAME OF SCHOOL *
CURRENT GRADE *
ETHNICITY (You have a choice not to answer) *
PARENT INFORMATION
#1 PARENT NAME (first & Last) *
ADDRESS *
EMPLOYER NAME *
OCCUPATION *
ADDRESS *
PHONE (CELL) *
WORK PHONE *
#2 PARENT NAME (first & last) *
ADDRESS *
EMAIL *
PHONE CELL *
BUSINESS PHONE *
EMPLOYER *
OCCUPATION *
HOW DID YOU HEAR ABOUT THIS PROGRAM *
DONATIONS WELCOMED
I would like to make a donation today that directly benefits girls in our area. Below is my tax-deductible donation.
CHECK ONE
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PERMISSION
When participating in Girls Talk activities, I(or the person I am registering) give consent to be interviewed, photographed, videotaped, or electronically imaged for the purposes of promotional materials, news releases, or other published formats for either the local Girls Talk  program or DREAMS Orgs. Inc. The images will be the sole property of the local Girls Talk or DREAMS Orgs. Inc I hereby release and hold harmless the local Girls Talk or DREAMS Orgs. Inc organization from any claim arising from the use of these images.
MEDIA PEMISSION SIGNATURE *
AGREEMENT
* Submit this registration form, along with the applicable membership fee online. Fees are not refundable or transferable to another person.*
I, agree that all the information provided above is true. I agree with the terms and conditions listed above *
TROOP INFORMATION
TROOP LEADERS FULL NAME #
CITY & STATE
SIGNATURE
SIGNATURE *
Pay Membership Online @
https://dreamsenterprise-101169.square.site/product/dreams-girls-talk-mentoring-program/10?cs=true
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