EMPOWERMENT 4 GIRLS

ZOOM SCHOLARSHIP QUESTIONNAIRE

Please complete the form below to be considered for a scholarship for Empowerment 4 Girls Zoom Sessions. All information you share will be securely stored and your personal information will only be shared with our staff and our Board of Directors. All financial and demographic data will be compiled anonymously for use in evaluating our programs and reporting our success rates to our funders.
Once you are done here, you must also complete a Zoom Session Registration form in order to complete your Scholarship Request. DO NOT MAKE ANY PAYMENT with your Zoom Registration if you are applying for a Scholarship. Choose the Session Scholarship on the Zoom Payments page. You will be notified regarding the status of your scholarship by email, and at that time we'll provide you a link to our Payments page so you can make your Scholarship Payment, if any due.

* Indicates required field

SCHOLARSHIP REQUESTED FOR WHICH Zoom Session Date(s)? *

Child's Name *

First

Last

Age *

Email *

Birth Date *

Phone *

Name (Parent or Legal Guardian) *

First

Last

Name (Parent or Legal Guardian) *

First

Last

How did you hear about E4G? *

If other, please share. *

What can you financially contribute to Zoom Session Registration cost ($0-$250)? *

Anything else to share? *

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A 501(c)(3) Nonprofit Corporation
EIN: 81-4391734
Your Privacy / Our Policy
COVID-19 Policy

Kristen Rubis
(360) 878-2043
hello@empowerment4girls.com

3403 Steamboat Island Rd NW #493
Olympia, WA 98502