2026 MAPP Program Registration Form

MAPP Program Registration Form

My Achievable Post-Secondary Plan April 25, 2026 - June 27, 2026, OR July 11, 2026 - September 19, 2026 (Every Saturday) - 10:00 AM- 12:00PM at the College of Westchester, 325 Central Ave., White Plains, NY., 10606. Register to participate in our MAPP Program. Please provide accurate information below.
Girls must commit to the full 10 session series.
COHORT 1 - April 25, 2026 - June 27, 2026 (Every Saturday)COHORT 2 - July 11, 2026 - September 19, 2026 (Every Saturday)
Participant Full Name*

First NameLast Name
Participant Email Address*
example@example.com
Participant Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Grade*
Name of School*
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name (if different from parent/guardian)

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list any medical conditions, allergies, food allergies, or special needs
YES
How did you hear about our MAPP program?*
T-Shirt Size*
YESNO
YES
Parent/Guardian Agreement: I certify that all information provided is accurate and grant permission for my child to participate in the 2026 MAPP Program.*

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Date*

MonthDayYear
Date
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