Next Steps Girls Write Now Inquiry Form Thank you for your interest in Girls Write Now! Please complete this form to receive the application and more information on our programming once enrollment for the next program year opens.Learn more at girlswritenow.org/enroll. Contact ID Contact & Personal Information First Name Last Name Email Address: Not you? Please go to https://girlswritenow.org/join/inquiry-form/. Your interest in Girls Write Now (check all that apply):I am interested in being a Mentee (must be between 14-24 years old or in at least 9th grade in the next academic year)I am interested in being a Mentor (must be 25 years of age or older)I am an educator or guidance counselor, interested in Girls Write Now programming for my students What are your pronouns? Please provide phonetic spelling of your name Phone number: Home City Home StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Guam American Samoa Palau Home Zip Code Demographics We continue to prioritize serving a diverse group and cultivating an inclusive network, and therefore respectfully request demographic information. This information will be used solely used for planning purposes to ensure we serve communities most impacted by the current realities in this country. Do you identify as biracial, multiracial, or two or more races?YesNoI prefer not to answer Please indicate how you describe yourself: Black or African AmericanHispanic/LatinxWhiteNative American/Native AlaskanAsian/Asian AmericanPacific Islander/Native HawaiianMiddle EasternOtherI prefer not to answer Please indicate how you describe yourself. Select all that apply: Black/African AmericanHispanic/LatinxWhiteNative American/Native AlaskanAsian/Asian AmericanPacific Islander/Native HawaiianMiddle EasternOtherI prefer not to answer If other, please specify: Age Range:Please select... Under 18 18-23 24-30 31-40 41-50 51-60 61 - 70 70+ I prefer not to answer Do you identify as LGBTQIA+?Please select... Yes No I prefer not to answer Employment Information Please enter information on your current position or the most recent. Employment StatusPlease select... Full-time Part-time Self-employed Unemployed Retired Student Job Title Company Name Company Website Company TypePlease select... Corporation Government Non-Profit/Association School or University Self employed Individual Other Employment SectorPlease select... Advertising Architecture Book Publishing Corporate/Technical Writing Design Education Fashion Film/Video Information Technology Journalism Magazine Publishing Marketing/Public Relations Medical Music/Audio Newspapers Nonprofit Online Media Radio Social Media Software Television Visual/Performing Arts Other If other employment sector, please specify School Information If you're taking a gap year or no longer in school, enter your most recent school information. School LevelPlease select... Middle School High School College Graduate School School TypePlease select... Public School Specialized School Charter School Private School Home School School Name School Website GradePlease select... 08 09 10 11 12 First-year Second-year Third-year Fourth-year Graduation Date Educator Grade(s) you currently teach:8th9th10th11th12thCollege/Graduate/Other Subject(s) you teach: School Name School Website School Street Address School City School StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Guam American Samoa Palau School Zip Code School Borough (ARCHIVE)Please select... Manhattan Bronx Brooklyn Queens Staten Island School Neighborhood (ARCHIVE) Do you have additional colleagues (teachers, guidance counselors, principals etc.) at your school who should also be notified once our enrollment opens?Please select... Yes No Are there specific students or student alumni you would like us to notify once our enrollment opens?Please select... Yes No Educator: Colleague Notification To add an additional colleague please click on "Add another response" in blue text in the bottom right hand corner of this section. Colleague First Name Colleague Last Name Colleague Job Title Colleague Email Address Optional: Colleague Phone Number Educator: Student Notification To add an additional student or student alum please click on "Add another response" in blue text in the bottom right hand corner of this section. First Name of student 1: Last Name of student 1: Grade student 1 will enter next year:Please select... 9th 10th 11th 12th Gap year College Graduate school Other If other grade, please specify: Email address of student 1: Optional: Phone number of student 1: ARCHIVED Professional Title/ID: (ARCHIVE) Home BoroughPlease select... Bronx Brooklyn Manhattan Queens Staten Island Other Guest Speaker/Teaching Artist Which genre/topic(s) do you have the most expertise? Show me a list of genre/topic(s) instead. Which genre/topic(s) do you have the most expertise? Please select as many as apply. Adaptation/Book to Film Analytical/Science Writing Audio/Podcasting Cartoon Comedy Code/UX Design Comedy: Standup/Sketch Cover Letters Digital Editorial Fiction Financial Literacy Graphic Design Graphic Novel Horror/Thriller Interviewing Skills Journalism/Nonfiction Marketing/PR/Social Media Memoir/Personal Essay Narrative Medicine Photography Playwriting Poetry Resume Romance Fiction Sci-Fi/Fantasy/Magical Realism Screenwriting/TV Writing Songwriting Suspense/Mystery Videography Wellness Westerns YA/Children's Literature Other If other, please specify. Generally speaking, when would you like to get involved?During the program year (September–June)During the summer (July–August)I'm not sure, but please reach out with relevant opportunities.I have a specific availability request. Please describe your specific availability request. Questions/Comments College Guide College Guides are volunteers who help our mentees with the college application process. They can lead workshops on how to craft components of college and scholarship applications and/or meet one-to-one with high schoolers and their mentors to provide advice and feedback on application materials and the college decision making process. What interests/excites you about being a College Guide for Girls Write Now? Do you have experience working with women, girls, and/or gender expansive individuals? Check as many that apply.I have experience working with womenI have experience working with teen girlsI have experience working with gender expansive youthI have experience working with gender expansive adultsI do not have experience working with any of the above populationsOther If other, please describe What experience do you have in helping students with the college application process? Check all that apply.I have experience being a college admissions officerI have experience being a private college coachI have experience teaching workshops on how to earn scholarships, craft the personal statement, make a college list, and/or decide on a collegeI have experience being a tutor to those applying to collegeOther If other, please describe Please describe your experience as it relates to being a College Guide for Girls Write Now. College Guides are asked to commit for a minimum of one academic school year (partial year optional upon discussion), providing up to, but no more than, 3 hours of support per month. College Guide activities include the following: Field mentee and mentor questions about the application process, how to earn scholarships/which ones to apply to, and moreServe as a panelist or presenter at select workshops (virtual or in person, safety permitting) to provide college readiness informationRecommend resources (online, over the phone, and in-person—when deemed safe) for preparing for the college application process and scholarshipsProvide support to our mentee/mentor pairs as needed, offering advice on the college application process and feedback on application materials and scholarship applications and/or college decision making Can you satisfy the College Guide time and activities commitment as it is outlined above?Please select... Yes, I can satisfy the commitment No, I cannot satisfy the commitment at this time Wellness Advisor: Your Expertise Are you a mental health professional licensed in the state of New York? Please select... Yes, only in New York State Yes, in New York and other state(s) No, I am not licensed in New York State How many other states are you licensed in?Please select... 1 2 3 4 5 More than 5 Please list the state(s) are you licensed in. What is your area of focus? Please select as many as apply. ADHD Bullying Child or Adolescent Depression Divorce Eating Disorders Emotional Disturbance Family Conflict Financial Stress Grief Immigration Peer relationships School Issues Academic issues Racial Identity Relationships Self Esteem Sexual Health Sexual Identity LGBTQIA+/Gender Identity Stress Other If other, please specify. Do you have experience working with women, girls, and/or gender expansive individuals? Check as many that apply.I have experience working with womenI have experience working with teen girlsI have experience working with gender expansive youthI have experience working with gender expansive adultsI do not have experience working with any of the above populationsOther What other population(s) do you have experience working with? Do you have experience working with teens and/or youth-centered organizations? Please note: This volunteer position involves advising/training individuals working with youth, not directly providing mental health services to youth. Please select... Yes No Please list the youth-centered organization(s) you have previously worked with. Please upload your professional resume here. Please provide proof of New York State licensure here. Please provide proof of licensure here. Please upload one for each state. Wellness Advisor: Your Commitment What interests/excites you about being a Wellness Advisor for Girls Write Now? What is your relationship to writing? Check all that apply. In my practice, I have used therapeutic writing with clients (e.g. journaling, etc.)I publish articles/I'm an authorI am not a writer, I'm a readerI take notes and document treatment plans, services provided, and client progress in accordance with APA guidelines Wellness Advisors are asked to commit for a minimum of one academic school year, providing up to 3 hours of support per month. Wellness Advisors activities include the following: Field mentors' questions and concerns (moderated by GWN staff) to offer strategies and advice for mentoring a teenServe as a panelist or presenter at select training sessions (virtual or in-person, safety permitting) workshops such as Wellness Wednesdays or Thursday Community Chats (or at the Girls Write Now office in Midtown when deemed safe), to provide mental health-related informationRecommend resources (online, over the phone, and in-person—when deemed safe) for teen mental health and well being that can be shared with mentors and GWN staff, and included on the GWN websiteProvide support to our mentee/mentor pairs as needed Can you satisfy the Wellness Advisor time and activities commitment as it is outlined above?Please select... Yes, I can satisfy the commitment No, I cannot satisfy the commitment at this time Contact Information Share This