Request a Scholarship

GALS INSTITUTE

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Our Therapists
Services
Resources
Gals on the Go
Gallery
Contact

Request a Scholarship

Please fill out ALL areas to be considered.

* Indicates required field

How did you hear about Gals On the Go Project Scholarship? (please choose one) *

Chosen by donor Requesting scholarship

If chosen by donor, who nominated you? *

Child's Name *

First

Last

Child's Date of Birth (MM/DD/YYYY) *

School Name / Current Grade *

Parent / Guardian Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Which workshops is your child interested in? *

Frenemy No More Frenemies Series Calm, Cool, Capable Kids Healthy Relationships - Self & Others 5' S of Self Esteem Resiliency 1,2,3 Other

Parent/Guardian Email *

Phone Number *

Please explain financial need, i.e. loss of job, high insurance deductible, etc: *

How would your child benefit from this scholarship? *

To be accepted to receive a GOTGP scholarship you will be required to complete post event surveys, share positive experiences/testimonies, and provide a photo of the participant. This helps GOTGP to spread the word of our mission and continue to raise funds to provide future scholarships. *

Accepts roles and responsibilities

E-Signature *

First

Last

Submit

Gals Institute, LLC
(262) 337-9770 | fax (262) 337-9771 | info@gals.institute
383 Williamstowne Dr., Suite 101 | Delafield, WI 53018
Located near Target in Delafield by the intersection of Hwy 83 and I-94