Entrepreneurs & Influencers Virtual Summer Camp Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Apply now for Entrepreneurs & Influencers (August 9 - August 20 1:00-2:30 pm)

Email *

Parent or Guardian Full Name *

Parent or Guardian Email (if different from above)

Parent or Guardian Phone Number *

Youth First Name *

Youth Last Name *

Youth Age *

Youth Email or Social Profile

Youth Phone Number

What is your zip code? *

What is the best way to contact PARENTS? *

Phone

Text Message to Phone Number

Other:

What is the best way to contact YOUTH? *

Youth Email

Youth Phone

Text Message to Phone Youth Phone

Parent/Guardian Email

Parent/Guardian Phone Call

Text Message to Parent/Guardian Phone

Other:

Tell us about your business or channel idea! *

Why do you want to be an Entrepreneur or Social Media Influencer?

Program Fees and Scholarships

Program fee is $300.00. Invoice will be sent to Parent/Guardian via email.

Thanks to financial support from The Heinz Endowments scholarships are available for youth in Hazelwood, the North Side, East Liberty/Lincoln/Larimar, the Hill District, Hilltop Communities, Wilkinsburg, and McKeesport!

10 spots available Register NOW!

All interested youth are encouraged to apply.

We live in a scholarship qualified neighborhood. See list above. *

Yes

**If No, Program Fee Invoice of $300.00 will be sent to Parent/Guardian Contact. **

Anything else you would like us to know?

Any additional questions?

Thank you! We are excited to have your youth join us!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms