Girls Link Up Interest Form

2024-2025 Mentoring Programs

Girls Link Up is a mentoring program for girls that supports their social and emotional needs while exposing and empowering them to S.T.E.A.M. college and career pathways. Girls Link Up works to bridge the gap between women and STEAM through engagement and exposure.
Student's Name

First NameLast Name
Current School Grade
We only accept girls in 3rd - 8th grade.
Current School
Date of Birth

MonthDayYear
Age:
Student ID Number
Please select all that you may be interested in attending.

PARENT/GUARDIAN INFORMATION
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Home Phone Number

Area CodePhone Number
Business Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
E-mail
Mom Circles

Mom Circles is an outreach program that is committed to equipping, empowering and educating mothers in the community with resources to support their social and emotional needs.
Are you interested in learning more about our Mom Circles Program?
Media Release Statement - Funding sources may require footage and evidence of program execution. Meetings may be recorded periodically. 1) I, the undersigned, authorize 3D Girls, Inc. to photograph, take motion pictures, take video footage, and/or make electronic sound recordings (herein referred to as photographic or electronic reproductions). 2) I authorize the use of any such photographic or electronic reproductions for any purpose, including, but not limited to educational and other public media as may be deemed appropriate by 3D Girls, Inc. (I understand that I may be identifiable from such photographic or electronic reproduction)
Should be Empty:

2024-2025 Mentoring Programs