Community Course Intake Form
We are so excited that you have chosen to partner with GirlVentures for one of our Community Courses! To confirm your Interest in one of our Community Courses, please complete this Intake Form. If you would like to book more than 1 Community Course, please complete an intake form for each Course.
Organization Information
Organization Type
Please select...
School
Organization
Government
Nonprofit
Organization Name
Street Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Point Person Information
First Name
Last Name
Phone Number
Email
Select the Course You Are Interested In
Course Applying For
Please select...
One Day Indoor Rock Climbing
One Day Outdoor Rock Climbing
One Day Kayaking.
One Day Hiking
Is this course an Affinity Course?
Yes
No
Bipoc or LGBTQ+
Please select...
Bipoc
LTGBQ+
Preferred Date
Anticipated # of Youth Participants
Anticipated # of Adult Participants
What would you like to gain with this trip with GirlVentures?
Please indicate which tier (and dollar amount) your School/Organization is able to contribute for the selected Community Course:
Please select...
Option 1 - $500
Option 2 - $900
Option 3 - $1200
Option 4 - $1500