EMPOWER GIRL AGE 15-19
Do you know a girl between the ages of 7-14 who is making a difference within her home, school and or community? A girl who stands up for what is right even when no one is looking? A girl who inspires those around her?A girl who is determined to change the world? If you answered YES to any of these questions, then we want to hear from you! All selected finalists will be invited to attend our Annual Mother Daughter Empower Conference & Awards (September 24th 2023, Simcoe County, ON) and entered into a chance to win some cool prizes along with an opportunity to become our Empower Girl of the YEAR! So what are you waiting for, let's go EMPOWER GIRLS!
YOUR Name
First Name
Middle Name
Last Name
YOUR E-mail
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YOUR Mobile Number
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Area Code
Phone Number
YOUR Relationship to the Nominee:
Nominee Name
First Name
Middle Name
Last Name
-> Pronouns
Nominees AGE
School Grade
-> Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
-> Please Tell us why YOU/ Your Nominee is an Empowered Girl. How is she making an impact within her home, school or community.
-> Please upload a headshot/ Photo of the Nominee here:
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-> Please upload any supporting documents/additional files, videos, certificates, links that you would like us to review.
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Mother Daughter Empower has permission to use all information provided in this form. I understand that my nomination can be featured online via Social media, newsletters, website etc..
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Yes, I understand.
I understand that if selected as a finalist, I will have to attend the 2023 Mother Daughter Empower Conference & Awards on September 24th 2023 in Innisfil, ON, Canada.
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Yes, I understand.
PLEASE ADD YOUR SIGNATURE HERE:
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