Being The CEO of ME Youth Entrepreneurship & Career Readiness Enrichment Program: 2022-2023

Being The CEO of ME Youth Entrepreneurship & Career Readiness Enrichment Program: 2022-2023
We love technology at MetIncPowerCo, but not more than your privacy and safety online. Please verify that you are human *
Student Name *

First Name Last Name
Parent/Guardian Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of school student currently attends *
Student Current Grade Level for this school year *
Being The CEO of ME School/Community Site Registration *
Do you have reliable internet to participate in activities that are web-based and online? *
What type of device will the student be using to log in and participate each week inside our Google Classroom? *
Afterschool Enrichment Transportation Plans *

My student will be picked up at 5pm afterschool My student needs transportation afterschool to site partner (Daycare, Boys & Girls Club) Other
Preferred Camp or Afterschool Cohort Start Date *

Month Day Year
Date
How did you hear about the program? (check all that apply)

My school My faith-based institution My community center Social Media- Facebook Social Media- Instagram Referral from a family member, friend Company Website Flier in a local business Chamber of Commerce Referral from a community partner (example: United Way of Greater Atlanta, SCWIB) Community Event Other
What is a Business Cohort: October 10, 2022-December 17, 2022
Transformation Team Cohort [Engineering Design Challenge] : Saturdays 9am-11am October 8, 15, 22, 2022. Students will help co-design a state-of-the-art classroom.
What is My Brand Cohort: January 9, 2022- March 6, 2023
Beta Testing My Product Summer Camp Intensive (Middle School & High School Only) Summer June 5-9, 2023 Macon-Bibb
Beta Testing My Product Summer Camp Intensive (Middle School & High School Only) Summer June 12-16, 2023 Clayton
Beta Testing My Product Summer Camp Intensive (Middle School & High School Only) Summer June 19-23, 2023 Henry
Is there any important information you would like share about your child’s preferred learning styles, requirements or habits? *
My student needs additional help in the following academic areas:

Reading Math Science Other
Student Learning Loss Scholarship Application & Completed Forms- File Upload (Limited Funded Scholarship; In-Person Afterschool Enrichment Students Only)

function SvgDhtupload(props) { return /* @__PURE__ */ react.createElement("svg", dhtupload_svg_extends({ width: 54, height: 47, xmlns: "http://www.w3.org/2000/svg" }, props), dhtupload_svg_path || (dhtupload_svg_path = /* @__PURE__ */ react.createElement("path", { d: "M40.213 10.172c1.897.21 3.68.738 5.35 1.58a15.748 15.748 0 014.374 3.242 15.065 15.065 0 012.951 4.533c.72 1.704 1.08 3.522 1.08 5.455 0 1.827-.28 3.654-.843 5.48-.562 1.828-1.379 3.47-2.45 4.929A13.39 13.39 0 0146.669 39c-1.599.948-3.452 1.458-5.56 1.528H37.26a1.62 1.62 0 01-1.185-.5 1.62 1.62 0 01-.501-1.186c0-.457.167-.852.5-1.186.334-.334.73-.5 1.186-.5h3.848c1.44 0 2.75-.37 3.926-1.108a10.851 10.851 0 003.03-2.846 13.53 13.53 0 001.95-3.9 14.23 14.23 0 00.686-4.321c0-1.582-.316-3.066-.949-4.454a11.623 11.623 0 00-2.582-3.636 12.857 12.857 0 00-3.742-2.478 11.054 11.054 0 00-4.48-.922l-1.212-.053-.37-1.159c-.878-2.81-2.292-4.998-4.242-6.562-1.95-1.563-4.594-2.345-7.932-2.345-2.108 0-4.005.36-5.692 1.08-1.686.72-3.136 1.722-4.348 3.005-1.212 1.282-2.143 2.81-2.793 4.585-.65 1.774-.975 3.68-.975 5.718h.053l.105 1.581-1.528.264c-1.863.316-3.444 1.317-4.744 3.004-1.3 1.686-1.95 3.584-1.95 5.692 0 2.39.8 4.462 2.398 6.219 1.599 1.757 3.488 2.635 5.666 2.635h4.849c.492 0 .896.167 1.212.5.316.335.474.73.474 1.187 0 .456-.158.852-.474 1.185-.316.334-.72.501-1.212.501h-4.849a10.08 10.08 0 01-4.374-.975 11.673 11.673 0 01-3.61-2.661 13.173 13.173 0 01-2.478-3.9A12.073 12.073 0 010 28.301c0-2.706.755-5.148 2.266-7.326 1.511-2.178 3.444-3.636 5.798-4.374.14-2.354.658-4.542 1.554-6.562.896-2.02 2.091-3.777 3.584-5.27 1.494-1.494 3.25-2.662 5.27-3.505C20.493.422 22.733 0 25.193 0c1.898 0 3.637.237 5.218.711 1.581.475 3.004 1.151 4.269 2.03a13.518 13.518 0 013.268 3.215 18.628 18.628 0 012.266 4.216zm-11.964 13.44l6.22 6.85c.245.247.368.537.368.87 0 .334-.123.642-.369.923l-.421.263c-.211.246-.484.343-.817.29a1.544 1.544 0 01-.87-.448l-3.69-4.11v16.97c0 .492-.166.896-.5 1.212-.334.316-.729.474-1.186.474-.492 0-.896-.158-1.212-.474-.316-.316-.474-.72-.474-1.212V28.25l-3.584 4.005a1.544 1.544 0 01-.87.448.959.959 0 01-.87-.29l-.42-.264c-.247-.28-.37-.588-.37-.922 0-.334.123-.624.37-.87l6.113-6.746v-.052l.421-.422a.804.804 0 01.396-.29c.158-.053.307-.079.448-.079.175 0 .333.026.474.079.14.053.281.15.422.29l.421.422v.052z", fill: "none" }))); }

DFCS United Way Learning Loss Scholarship Fillable English Form: (Directions: Copy + Paste link in browser/Complete Form + Save to computer/Upload) https://drive.google.com/file/d/11im3BaIOsZ5dMJwIakklJ_S1hd457dkI/view?usp=sharing ----------------------------------------------------------------------------------------------------------------- DFCS United Way Learning Loss Scholarship Fillable Spanish Form: (Directions: Copy + Paste link in browser/Complete Form + Save to computer/Upload) https://drive.google.com/file/d/1Un__DpLwTHU1T1RlNhyq3Sqq1zqwPima/view?usp=sharing
Cancel of
Learning Loss DFCS Scholarship Eligibility: What are the youth eligibility requirements for Learning Loss funding through MetIncPowerCo? To be eligible, youth must:  Be a U.S. citizen or legal immigrant;  Be a Georgia resident;  Currently receive Supplemental Nutrition Assistance Program (SNAP)/Food Stamps, Temporary Assistance for Needy Families (TANF), Medicaid or Supplemental Security Income (SSI) or have a household income 300% or less of the Federal Poverty Level (FPL);  Be 5 - 17 years old or be 18 years old and currently enrolled in school (high school, GED program or equivalent, or post-secondary institution) and will be enrolled in AND attend school during the upcoming academic year (verification of school enrollment includes a letter from the school on official school letterhead) or be 18 - 19 years old and have a dependent child AND be the custodial parent. ---------------------------------------------------------------------------------- If you are applying for a student scholarship, Type "I UNDERSTAND" in the box below
Being The CEO of ME Program Add-ons *
prev next ( X )
Being The CEO of ME Enrichment T-Shirt
$ 20.00 Size Quantity

Being The CEO of ME Entrepreneur Big Ideas Journal
$ 15.00 Quantity

Being The CEO of ME Dry Erase Get It Done Calendar
$ 20.00 Quantity

Total

$ 0.00
As the parent/guardian of student name I understand the Being The CEO of ME Youth Entrepreneurship & Career Readiness Program by Metamorphasis Powerhouse Company is an optional program, where my student's success will largely be benefited from my son/daughter's regular attendance, willing to be coached and mentored, and execution of all assignments and projects. I understand that my student's enrollment in the program is subject to following code of conduct standards including but not limited to the academic standards, internet policy, social media use policy, and anti-bullying policy.

By participating in the Being The CEO of ME program, I understand that I am giving my express permission for my son/daughter, student name to be filmed, photographed, and streamed online, on websites and social media pages pertaining to the Being The CEO of ME program, including but not limited to during virtual, and in-person workshops, field trips and events.
I am interested in volunteering:

Field Trip/ Community Learning Lab Chaperone (2nd Saturday/month) KID CEO Marketplace (Quarterly) Pitch Perfect SharkTank (Quarterly) Entrepreneur/ Small Business Shadow Day Parent Engagement/ Parent University Fundraising Other
Signature *

Clear

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty: