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Play Like a Girl Programs Interest Form

Thanks for your interest in Play Like a Girl Programs!
Complete this form below to tell us a bit more about yourself. You’ll be the first to know when program applications are available.

1 Step 1

First Name

Last Name

Preferred NameIf different from above

I am a...

Middle school student (girl) interested in participating in Play Like a Girl programsParent, guardian, family member or other adult responsible for a girl interested in participatingEducator, role model or community volunteer interested in facilitating programs for girls Company or individual interested in sponsoring a girl or Play Like a Girl programOther

EmailEx. [email protected]

Cell PhoneEx. 555-555-5555

Employer(Type NA if not applicable)

Job Title(Type NA if not applicable)

City

State of Residence

Student’s Grade in School

Past Play Like a Girl Program Participation

Summer, Fall or Spring Break Camp(s)Meet + Mentor virtual mentoring programAn Inside Look corporate field trip(s)STEM+ Challenge or hackathonPlay Like a Girl Campus ClubStudent Leadership AcademyField Day sports clinic(s)None of the above

Please confirm below that Play Like a Girl may reach out to you and share updates on its programs and other opportunities.

YesNo

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Emaila valid email

Play Like a Girl is a 501(c)(3) charitable organization recognized as a public charity under federal EIN 33-1149207.