Parent, Guardian or Family Application

Parent and Family Application

Attention Current Parents/Guardians: Parent Application is Due by July 5. Attention: New Parents/Guardians: Parent Application is Due by September 1.
The First Ladies Youth Leadership Foundation, Inc. (First Ladies) is excited about your young lady(ies) applying to our afterschool mentor leadership program. First Ladies specifically addresses issues that impact girls in grades 6-12. There are 3-12 pillars of focus or tagret areas: (1) Purpose/Identity Development/Mental Health, (2) Mentorship, (3) Leadership, (4) High School Readiness, (5) College Readiness, (6) Career Readiness, (7) Building Healthy Families, (8) Building Sisterhood, (9) Etiquette, (10) Financial Literacy, (11) Community Service and (12) Entrepreneurship.

This program is designed with your young lady in mind and seeks to provide positive role models to support our mentees who are thoroughly vetted with background checks via the State of Georgia or the local county and are classified as Mandated Reporters.

In partnership with educational, faith and community leaders, you as the parent or guardian, your child/youth, and your family are very essential to the successful outcomes of our mentees' 21-week mentoring expereince.

To begin the path of success, please be sure to: (1) complete the parent/guardian application along with submitting the application fee; (2) the student completes the student application along with the requested materials; (3) Recommendation forms are requested and returned; (4) Attend the infrmational/interest meeting; (5) attend the Virtual Interview Day.

Application Fee

The Application Fee is due by July 5 for Current First Ladies families and by September 1 for new applicants. Payment methods are: Zelle imentor@firstladiesyouthleadershipfdn.org),Cash App at ($FirstLadiesFdn) or PayPal (see link below).

The Application Fee is $50. It goes towards the Annual Dues and is

deducted from the annual $150 dues.

Sponsorships are available. No child will be turned away because of a financial challenge communicated within the application process. If there is a financial issue, email imentor@firstladiesyouthleadershipfdn.org and ask for sponsorship details before August 31.

First Ladies Annual Dues go towards the Annual Launch, Induction Ceremony, Student Birthday Celebrations, or the End of Year Scholarship Awards Banquet. Additional Details Made Available During the Program.

Student Application/Essay/Voice Recording/Photo

Grades 6-12 students are responsible for completing the student application by the deadline. The application process is a part of the First Ladies college readiness pillar and is a glimpse into a college common application process. It is also a way to see if First Ladies is a good match for a family and to be a learning process for scholarship applications, work based learning opportunites and college admittance.

Grades/Discipline Report

The parent or child can submit these reports. Grade 6 students with no discipline report can upload a blank page with the words "No Discipline Report" on the form. Reports must be submitted by September 1. The links have been made available via this form.

Recommendation Forms

Teacher Recommendations forms (1) Community Leader and All Core Teachers - Math, Science, English - must be submitted by new applicants. Current applicants only need to submit teacher recommendation forms.
To access the Teacher Recommendation Form, copy and paste the link below. Recommendations from the present or previous year's teachers are acceptable.

Click the following link: https://form.jotform.com/222084027689158

To access the Community Leader Recommendation Form, copy and paste the link below. The Form can be completed by a mentor, pastor, coach, employer, etc.

Click the following link: https://form.jotform.com/222083980303148
Optional: To Attach Link to Child's Video Essay, Upload Video (3 Minutes or Less) Here

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Parental Consent

Instructions: Please type in your initals or fill in the blanks.
I, the undersigned   First NameLast Name   , am the parent or legal guardian of the child/youth named   First NameLast Name   , my child was born on   Date of Birth  and resides in   Street AddressAddress Line 2CityStateZip    . The best contact number for me is Area CodePhone Number and my preferred email address is   Email

Type a label   I understand that First Ladies is a 21-week afterschool leadership development program that is a faith-based and community-based partner to grades 6-12 schools and is not a school-based program.

Type a label   I understand that my child/youth will meet with one of the First Ladies middle or high school chapters once a week (typically on Thursdays) after school for 3-4 weeks out of the month for one hour and fifteen minutes from September - May. My child would be expected to be present for at least 19 out of the 21 meetings/events/activities. Failure to do so may result in student removal.

Type a label   I also understand that my child/youth will be required to participate in 1-2 activities per month on the weekend for a Signature Event or MAC group meeting, activitity, or community service.Failure to do so may result in student removal.

Type a label I give my permission for my child/youth to participate in all aspects of the program.

Type a label   I understand that I will be responsible for any travel to and from any program activities and that pick-up and drop off will be done in a timely fashion. Failure to do so may result in student removal.

Type a label   I will support the mentor match by communicating with my child/youth's mentor, reviewing the monthly calendar and attending the parent meetings monthly.

Type a label   I also give my permission for my child/youth to share personal information with her mentor, as appropriate, and understand that the information will be confidential unless at any time the mentor is concerned about any safety issues.

Type a label   I understand that my child/youth's participation in First Ladies is voluntary and that she can withdraw from the program at the end of the school year. If there is a reason or need for withdrawal before the end of the school year, I agree to contact First Ladies and complete an exit interview before withdrawal.

Type a label   I agree to the use of my child/youth's photo on the First Ladies website, newsletter, social media outlets, and other forms of program material.

My child currently has/had the following conditions/diseases:   ChickenpoxMeaslesMumpsAsthmaSinusitisBronchitisDiabetesHeart TroubleOther Conditions/Diseases   , and has these allergies:   Insect StingPollenNutPoison Ivy, OakSoyWheat,   Other Allergies.

Type a label   I agree to pay for any and all medical expenses incurred and give permission to the doctor or health care professional to provide medical care if necessary.
First Ladies teaches its participants the importance of dreams and goals. Please briefly share you/your family's goals for your child/youth in general and why you want her to join First Ladies?
Attach Your Child/Youth's Discipline Report. Upload Document Here.

This can be obtained from the school's records clerk or counselor.
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One of the First Ladies pillars is high school, college and career readiness. After completing three successful years in First Ladies, high school seniors are eligible for the Wanda Lynette Hill Scholarship. Please share if you want your child/youth to go to college? If you have begun planning for her college entrance? If so, please briefly share how you have begun preparation and how you would like First Ladies to help with your child/youth's education. (i.e.. haven't started yet, 529 savings plan, scholarship applications, etc.)
Attach Your Child/Youth's Most Recent Grades Report. Upload Document Here.

This can be obtained from your child/youth's student portal (i.e. Infinite Campus) or the school's records clerk or counselor.
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One of the First Ladies pillars is financial literacy and entrepreneurship. First Ladies is in partnership with Bank of America to provide your child/youth with financial tools. Will you be responsible for ensuring that your child/youth has access to a computer or laptop and will complete the 4+ month simulation/project/activity?*
Emergency Contact Person

(different than the person who has primary guardianship)
Relationship to the child blanks*. In the case of an emergency, do you permit this person to pick up your child from a First Ladies activity? (yes or no) blank*
Emergency Contact Person's Name

First NameLast Name
Emergency Contact Person's Phone Number*
Please enter a valid phone number.
Emergency Contact Person's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NOTICE OF NONDISCRIMINATORY POLICY AS TO OUR PARTICIPANTS

The First Ladies Youth Leadership Foundation, Inc. admits female youth of any race, color, national and ethnic group to all the rights privileges, programs, and activities generally accorded or made available to its female youth leaders in First Ladies. It does not discriminate based on race, color, national and ethnic origin in the administration of its educational policies, admissions, general policies, sponsorship, and other programs.

I hereby voluntarily release, forever discharge the community, the corporation, the school, its officers, directors, employees, volunteers, and agents from any and all claims, demands, or causes of action, which are connected with my child/youth's participation in First Ladies or the use of the equipment and facilities.

The information I've given in this form is complete and accurate. If I have any questions, I can attend the August parent informational or email imentor@firstladiesyouthleadershipfdn.org for more information.

By signing this form, I confirm that I have fully informed myself of the contents of this Parental Consent and Release Form by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.
Parent/Guardian Signature*

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Registration/Application FeeSchool-Year 2025-26 Payment goes towards the $150 annual dues.
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Parent and Family Application

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