Community Leadership Camp Questionnaire

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Thanks for providing this information early and promptly. This camp is going to be a SPECTACULAR experience for the girls, and to do so we want to make sure we have it personalized and have all the details right, so it can really shine.

Email *

Name of camper:

Any allergies or health issues we should be aware of?

Parent/caregiver contact information:

Emergency contact (other than parent/caregiver):

Would you like the book in hard copy form or audiobook?

Hard copy

Audiobook

Clear selection

T-shirt size (women's fitted shirts, they run small):

XXL

Clear selection

What do you hope to get out of the camp?

What are some of your passions and interests?

Please check all that you would be interested in for internships:

Passalongs Flower Farm and Florist (wedding preparation)

Florence Barber Shop

Tiffany Chapman Photography

Marcella NYC (clothing design)

Fed by Foley (catering)

Ascendance Inner World Arts (dance)

Mayor Sciarra

CopyCat Printers (graphic design)

Pie Bar

Busy-Bee Cleans (social media)

Cycle Pottery

Telebelle Hair Salon

Kidstuff Thrift Shop

The Wild Chestnut (vegan bakery)

Greenfield Bank

DeLap Real Estate (real estate agent)

Northampton Fire Department (female firefighter working to become chief)

Academy of Music (theater management)

A2Z Toys and Learning Center

Other:

What other businesses or professions are you interested in learning about?

Anything else you'd like us to know?

Favorite color?

Favorite animal?

Favorite place?

Favorite song?

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