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Girl Ambassador Program Application

Girl Ambassador Program Application

Fill out the form below to submit an application to the 2021 Girls For A Change Girl Ambassador Program.

Step 1 of 6 - Participant

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  • Participant Information

    In this section, we'll need information for the participant who wishes to apply to the Girl Ambassador Program.
  • This option applies to 11th and 12th grade girls only.
  • Accepted file types: pdf, doc, docx, txt, rtf.
    If the applicant does not have a resume, send what you can to reflect their school, community, and volunteer activities.
  • Accepted file types: pdf, doc, docx.
    Please upload a reference letter as a Word document or PDF.
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  • Participant Program Information

    Please tell us more about yourself in the section below.
  • List middle and high school activities in order of importance.
  • List public service and community activities in order of importance. Do not repeat items listed previously.
  • List club/organization activities in order of importance. Do not repeat items listed previously.
  • List awards, scholarships, publications, or special recognition you have received in order of importance.
  • Highlight a problem or need of society you want to address as a leader in STEAM, other academic area, and/or career setting. (If possible, use statistical data to define the magnitude of the problem.
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  • Emergency Contact Information

    Please provide contact information we should be aware of in the case of an emergency.
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  • Medical Treatment & First Aid Information

  • Please check the box below to grant medical treatment/first aid authorization.
  • Please type N/A in the box below if your child is NOT allergic to any medications.
  • Please type N/A in the box below if your child is NOT currently taking any medications.
  • Health Insurance Information (Optional)

  • Transportation Consent

    Please tell us who will be picking up the participant from Girls For A Change?
  • Marketing Consent

  • Unless a letter to the contrary is received, GFAC accepts your consent for us to take photos and share them on social media as well as GFAC main website.
  • Release From Liability

  • Rules of Conduct (must be read by Parent/Guardian AND Participant)

    For Participant

    You are representing yourselves, your family and community. We expect you will represent us well, and display mature and responsible behavior expected of respectable young women in society.

    1. All participants are expected to demonstrate common courtesy and respect at all times. Inappropriate language/behavior will not be tolerated.
    2. Participants should be modestly dressed. Writing on clothing should be respectful and positive.
    3. The possession or consumption of any alcoholic beverage and/or possession/use of any illegal drug by an individual is not permitted.
    4. Smoking is not permitted.
    5. Weapons and/or drug paraphernalia are not allowed.
    6. Prescription drugs need to be given to a staff member for storage and distribution.
    7. No Eating, chewing gum or liquids are allowed in the training spaces.
    8. The Girl Ambassador Program has a strict policy regarding the possession and usage of electronic devices during instructional time.
    9. Participants are required to attend all scheduled Girl Ambassador meetings and training.
    10. Girl Ambassador participants are allowed no more than three (3) excused or no unexcused absences during the training period. It is the participant's responsibility to notify Girls For A Change that she will be absent, by calling and emailing us.

      Absences may be excused for the following reasons, with appropriate documentation:
      • Doctor appointment
      • Death in the family (2 per session)
      • Religious commitment
      • Illness
      • Family Emergency IE: Car accident, hospital emergencies (1 per session)
      • Testing ( 3 per session )
      • School visit ( college tour)
      Generally, our partner will provide its employees with a handbook or workplace policies to set forth expected behavior and procedures within the workplace. All participants are expected to abide by their rules and regulations for their employees.

    *Violation of these rules may lead to counseling, parental conference, or unfortunately, dismissal from the program.

    For Parent/Guardian

    All participants are expected to dismiss on time. A late fee of $5/minute will be assessed beginning at 5:05 p.m. If a child remains at the location beyond 30 minutes, without any form of communication to Girls For A Change staff members, we will reach out to your ER contacts listed. If an emergency arises that will delay pick up, we must be notified immediately and another person authorized to pick up your child up must come.

    1. A call to the parent’s workplace and/or home.
    2. A call to those authorized to pick up the child.
    3. A call to the emergency contact.
    4. A call to the local police department and Child Protective Services.

    PICK UP BY AN INTOXICATED PARENT OR AUTHORIZED REPRESENTATIVE

    CAMP DIVA will not permit parents or authorized representatives who are intoxicated to pick children up from our camp location. We do not wish to expose the location to any legal action for the improper release of children, but more importantly, we do not wish to expose the children enrolled in our programs to any danger resulting from their parents’ or authorized adult’s impaired faculties. Therefore, we will expect our staff to be alert to the possibility of parental intoxication, and if there is evidence of such intoxication by means of speech, gait, or manner, that staff member will call a second staff member to corroborate. If both staff members agree that the parent is intoxicated, the staff will not permit transportation by that person, and the Richmond Police Department will be called to assist the program staff in determining the course of action to be taken. If the parent insists on removing a child in spite of these actions, a conference will be held that week between the parent and the Director that could result in termination of the child’s participation in the program.

    NON-CUSTODIAL PARENT POLICY

    A parent of a child enrolled in the program who is not the child’s custodial parent will be permitted unlimited access to the camp location and be afforded the same rights as the custodial parent unless there is court documentation limiting access and contact by the non-custodial parent. This documentation must be on file in our office. Upon entering the camp location, the non-custodial parent must report to the director or designee in the child care office.

    GRIEVANCE POLICY FOR PARENTS

    It is the intent of the Girls For A Change programs to provide all parents and guardians with an avenue for discussing and resolving any concerns they may have with regard to the care being provided by the center. When a concern has been identified, the parent should first discuss the issue with the program staff members. It is suggested that in order to facilitate the conversation, an appointment should be scheduled and the individual requesting the appointment should prepare a written list of pertinent discussion points prior to the appointment. Notes of what was discussed and agreed to during the meeting are also encouraged. Once the staff member(s) has/have addressed the issue, based on the response, the parent or guardian should consider the issue resolved. If the staff member was unable to address the issue because of its administrative nature, or if the parent or guardian is dissatisfied with the response or outcome, he/she should then discuss the issue with the Director. At that meeting, the parent or guardian should be prepared to discuss what has transpired to-date. The Director will research the issue and respond to the parent in a follow-up meeting, or at the initial meeting if no research is needed.

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  • GFAC Girl Ambassador Program Fees

  • Price: $50.00
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  • $0.00
  • This field is for validation purposes and should be left unchanged.
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Girls For A Change (GFAC) is a 501(c)(3) nonprofit youth development organization aimed at empowering Black girls and other girls of color in Central Virginia to visualize their bright futures and potential through discovery, development, innovation, and social change in their communities.

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100 Buford Road
North Chesterfield, VA 23235

(804) 405-2827

info@girlsforachange.org

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