check

Rites of Passage Application

Participant Application

Click the button below to start.

Start

Question 1 of 23

Full Name:

Question 2 of 23

Date of Birth (MM/DD/YYYY):

Question 3 of 23

Age:

Question 4 of 23

Address:

Question 5 of 23

City:

Question 6 of 23

State:

Question 7 of 23

Zip Code:

Question 8 of 23

Phone Number:

Question 9 of 23

Email Address:

Parent/Guardian Information

(For participant's parent/guardian)

Question 11 of 23

Full Name:

Question 12 of 23

Relationship to Participant:

Question 13 of 23

Phone Number:


Question 14 of 23

Email Address:

Question 15 of 23

Personal Statement

 

In a separate document, please provide a personal statement (500 words) addressing the following points:

  •  Why do you wish to join I Am My Daughter Rite of Passage Program?
  •  What do you hope to gain from this experience?
  •  How do you see this program contributing to your personal growth?

file_upload
insert_drive_file

Question 16 of 23

New Question

file_upload
insert_drive_file

Question 17 of 23

Letter of Recommendation

Please include a letter of recommendation from a teacher, mentor, or community leader who knows you well. The letter should address your character, strengths, and why you would be a good fit for this program.

 

file_upload
insert_drive_file

Question 18 of 23

Commitment to Participation

 

By applying to this program, you are committing to attend all four sessions on the following dates from 10 AM to 4 PM:

 

July 7, 2024

July 14, 2024

July 21, 2024

July 28, 2024

 

Please confirm your availability for these dates:

 

A

Yes, I am available for all four sessions.

Question 19 of 23

Health Information

Do you have any medical conditions or allergies we should be aware of?
If yes, please describe:

Question 20 of 23

Emergency Contact Name:

Question 21 of 23

Emergency Contact Phone Number:

Question 22 of 23

Financial Commitment

The total investment for the program is $2,000. A $500 non-refundable deposit is required upon acceptance to secure your place in the program. The remaining balance of $1,500 is due before the program commencement date.

I understand the financial commitment required and agree to the terms:

(Select all that apply)
A

Yes, I agree.

Question 23 of 23

Parent/Guardian Consent

I, the undersigned parent/guardian, consent to my child’s participation in I Am My Daughter Rite of Passage Program.

(Please type your full name with the date of application)

Confirm and Submit