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Radiant G Conference Interest Form
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1
Name
*
This field is required.
First Name
Last Name
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2
Email
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By completing this form, you consent to receive email updates from Girls Empowerment Network.
example@example.com
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3
I am a:
Donor
Educator
Girl/Youth
Parent/Family Member
Volunteer
Other Girl Advocate
Other
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4
School
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5
Grade
2023-2024 School Year
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Other
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6
Would you like more information about participating with a large group (5+ individuals)?
YES
NO
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7
Where are you located?
Austin/Central Texas
Houston
Dallas
San Antonio
Other Texas
Other
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8
Have you or your child attended Girls Empowerment Network programs in the past? (Select all that apply.)
Yes - Camp
Yes - Girl Connect
Yes - We Are Girls Conference
Yes - Spark Kits
No - this is their first time at Girls Empowerment Network!
Other
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9
Additional Comments
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10
Graduation Year
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11
Contact Record Type
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12
Relationship to GIRLS
Donor
Guardian/Parent
School Contact
Volunteer
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13
Description
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