Girl Smile | 2026

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2
Name* This field is required.
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Date of Birth* This field is required.
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Email* This field is required.
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Address* This field is required.
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Afghanistan
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Maldives
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Mongolia
Montenegro
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Myanmar
Nagorno-Karabakh
Namibia
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Race/Ethnicity* This field is required.
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8
Which best describes your connection to Girl Get Up Society?* This field is required.
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Current participant
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9
What type(s) of support would be most helpful right now?
Food/Groceries
Restaurant Gift Cards
Gas Assistance
Rent/Housing Support
Utility Assistance
Childcare Support
Hair Appointment
Self-Care Support
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Professional Development
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10
Please briefly tell us what support would make the biggest difference for you right now.* This field is required.
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11
Name of Person Being Nominated
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Age of Person Being Nominated
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Phone Number (if known) of Person Being Nominated
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14
Why are you nominating this person for Girl Smile support?
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15
What type of support do you believe would benefit them most?
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Terms and Conditions* This field is required.
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