BasicInformation DateofBirth,ContactInformation(Address,City,State/Province,Country,Zip/Postal Code,PhoneNumber),SchoolInformation,ParentorGuardian'sContactInformation Characteristics Wewantadiverseteam-diverseintermsofethnicity,culturalbackground,geographiclocation, familyeconomicsituation,educationalbackground,andpersonalities!Towardsthatwewouldlike foryoutogiveusalittledeeperideaofhowyouviewyourself.Remember,wearenotlookingfor specificanswerstothesequestions-basicallywewilltakeamixofgirlswhospanthespectrumfor eachofthese. 1.Doyouraiseyourhandandparticipateinclass? Notreally,I'mmoreofaquietlistener Yes Sometimes 2.Doyouplantogotocollege? No Yes Unsure 3.Dideitherofyourparentsgotocollege? No Yes 4.Doyouworkoutsideofschool? No Yes 5.Myfavoriteclassis: Science Math English Art History Sports Music Other______________________ 6.Myfriendsconsiderme(Checkallthatapply): Outgoing Shyorprivate Funny Aleader Asciencegeek Artsy Tough Athletic Other______________________ 7.IfeelIcanbestbedescribedas: AmericanIndian,FirstNationorAlaskaNative Black Chinese,Japanese,Taiwanese,Korean Indian,orfromtheIndiansub-continent Latina Mixedrace(includingBlack,Latina,orAmericanIndian/FirstNation/AlaskaNative) Mixedrace(notincludingBlack,Latina,orAmericanIndian/FirstNation/AlaskaNative) SoutheastAsianorPacificIslander White Other______________________ 8.Whatkindofneighborhooddidyougrowupin? Innercity Urban Suburban Rural Other______________________ 9.Howwouldyoudescribeyourfamily'slifestyle? Upperoruppermiddleclass Middleclass Lowermiddleorworkingclass Other______________________ 10.Doanyofthefollowingapplytoyou?(Checkallthatapply): *Notethatthisquestionisoptional.InspiringGirlsExpeditionsstrivetocreateasafeandsupportive spaceforgirlsofalltypes.Justaswithanyotherquestion,youranswertothiswillnotaffectyour selectionfortheprogram,butwillhelpusgetasenseofwhoyouareandenableustobuildadiverse team. Daughterofasingleparent Daughterofdivorcedparents Notlivingwithparents Livedorcurrentlyliveinfostercare Comingfromanactivemilitaryfamily Recentimmigrant FirstgenerationAmerican LivedorcurrentlyliveonIndianreservationorinAlaskanativevillage HealthandWell-Being PleasenotethatifyouareacceptedasamemberofanInspiringGirlsExpedition,youwill berequiredtohaveabasicphysicalandamedicalformsignedbyyourdoctor.While similartothatrequiredbymanyschoolsforsportsprograms,ourmedicalformisunique withquestionstargetedtomountaineeringandbeinginaremotewildernesssetting.You willneedtogetourformcompletedbyaphysicianorphysician'sassistanttobeableto participate.Pleasefeelfreetocontactuswithquestionsatanytimeregardingthis requirement. Howfastcouldyourun2milestoday? Ifyouhaven'trun2milesrecently,pleaseasksomeonetohelpyoutimeyourself. Howmuchdoyoutypicallyexerciseduringaweek? Pleaseprovidetheactivity,duration,andnumberoftimesperweek(forexample:running, 30minutes,2timesperweek). Whatisthemostchallengingrun,hike,orwalkyouhaverecentlydone? Pleasedescribethisexperience(howfaryouwent,howlongagoitwas,theterrain:mostly flat,littlehills,orbighills;pavedroad,mountaintrail,orbeachwalk).,whenyou accomplishedthis,andwhatyoulearnedthatwillhelpyoutrainforInspiringGirls Expeditionsifyouareaccepted. Areyoucapableofcomfortablyswimming25yardscrawlstrokeindeep water,facedown,breathingalternatesides,thentreadingwaterfor1 minute,andthenswimmingback? Weaskthisbecausethekayaking-basedexpedition"GirlsinIcyFjords"requiresthatwe selectgirlswhoarecomfortableindeepwaterforsafetyreasons.WerecommendRedCross swimminglevel3ataminimumandwilldiscussthismorewithyouifyouareselectedfor theteam. Yes No Betterphysicalfitnesswouldhelpyouenjoytheprogrammore.Would youbewillingtotrainifyou'reacceptedontotheteam? Aspartoftheprogram,youwillbeexpectedtowalkupto5-8milesperdayoveruneven terraincarryingapackthatweighs40pounds. No Yes InspiringGirlsExpeditionsareveryphysicallyandemotionallydemanding programs.Withthatinmind,InspiringGirlsExpeditionsarenotan appropriatechoiceforindividualsdealingwithsignificantbehavioral, emotional,medicalorrehabilitationissues.Arethereanyofthe followingissuesthatwewouldneedtobeawareofand/oraccommodate inordertoprovideasafeandsupportiveenvironmentforyouandyour team?Pleasereadthetwofollowingquestionsthoroughly,andanswer honestly.Pleasenotethatwemaydiscusstheseissueswithyouandask tospeaktoyourdoctorpriortoyouracceptanceontheprogram. Doyouhaveanyphysicallimitationsormedicalconditionsthatwould makecamping,hikingorlivingoutsidechallenging?*** Pleasechooseanythatapply: Nophysicallimitationsormedicalconditions Epilepsy Diabetes Allergies Seizuredisorder Dizziness,vertigoorfainting Respiratoryissues Asthma Hepatitisorliverdisease Cardiacissues Weight50poundsorgreaterthantheaverageforyourheight Brokenanybonesorsustainedanyseriousjoint,muscleorbackinjuriesinthepast3 years EmergencyRoomvisitinthepast3years Other Furtherinformationonphysicallimitationsormedicalconditions*** Pleaseprovideuswithmoredetailonyourphysicallimitationsormedicalconditions,so thatwecanbetterprovideasafeandsupportiveenvironmentforyouandyourteam. Doyouhaveanymentalhealth,behavioral,oremotionalconditionsthat mightmakedoingrigorousphysicalactivity,beinginanunfamiliar landscape,beingwithanewgroupofpeople,andbeingpushedoutside ofyourcomfortzonechallengingforyou?*** Nomentalhealth,behavioraloremotionalissues Anxiety-mild,moderateorsevere Depressionand/orsuicidalthoughts Eatingdisorders Psychologicalorbehavioralproblems Neurologicaldiagnosis Pastorcurrentdrug,alcohol,ortobaccoaddiction Other Furtherinformationonmentalhealth,behavioral,oremotional condition*** Pleaseprovideuswithmoredetailonyourmentalhealth,behavioral,oremotional conditions,sothatwecanbetterprovideasafeandsupportiveenvironmentforyouand yourteam. ***Exceptinextremecasesaffectingsafetyoftheteam,youranswertothisquestion willnotaffectourdecisiontoacceptyou,butitwillallowustobeginthinkingabout howbesttoaccommodateyourneedsandtocreateadiverseandmutually supportiveteam.Ifyouhaveanyquestionsaboutthis,pleasecontactus. AboutYou Pleaseanswerthefollowingquestionswithoneortwoparagraphs.Itismoreusefultothe applicationreviewcommitteeifyouprovidespecificexamplesortellstoriesratherthan answeringingeneralstatements.Youranswersinthissection,whicharelimitedto900 characters,arethebestwayforustolearnaboutwhoyouare.Wesuggestyoucompose youranswersinaseparatetexteditingapplication(suchasWord),haveanadultreadthem andprovidefeedback,andthencopyandpastethemintheboxesprovided. 1.PleasedescribeyourinterestinInspiringGirlsExpeditions. Whydoyouwanttoparticipateinthisprogram? 2.Howdoyouspendyourdaysandweekendsoutsideofschool?Whatis atypicaldayandatypicalweekendlikeforyou? 3.Whatdoyoufeelisoneofthemostimportantrecentscientific discoveriesorongoingscientificquestions? Whatisitaboutthisdiscoveryorquestionthatinterestsyouorconnectswithyourlifein someway? 4.Describeyourrelationshiptoorexperiencewithartasatoolfor expressionandcommunication. Here,'art'caninclude(butisnotlimitedto)drawingandpainting,sculpture,music,dance, theater,photography,writing,oranykindofactivityyouusetoexpressyourselfcreatively. 5.Whatdoyoufeelareyourstrengthsoroutstandingqualitiesof character?Whatdoyoufeelareyourweaknessesorareasinwhichyou wishtoimproveyourcharacter? Pleaseprovidespecificexamplesortellstoriesratherthanansweringingeneralstatements. 6.Whatwouldyouliketobedoinginallaspectsoflife(e.g. career/school/personallife)insixyears? 7.Whatareyourideasonhowyoumightfundraiseifselectedto participateonanexpedition? Examplesinclude:bakesales,yardwork,babysitting,choresforneighbors,sponsorship fromalocaloutdoorstore.Note:Whiletheprogramistuition-free,withfoodandgearcosts coveredforthedurationoftheprogram,weexpectyoutomakeacontributiontowardyour travelcosttogettothestartinglocationofyourprogram.Ifyourfamilyisunabletopayfor theflights,weaskyoutofundraiseamodestcontribution.Thishelpsusprovidemore experiencesformoregirls,andithelpsyoufeelcommittedtobeingonourteam.Wewill sharestrategieswithyouonhowtodothis.Ifyouarechosenfortheteam,wewillwork withyouandyourfamilytodiscussoptionsforcoveringyourtravelcosts. 8.Howwouldyoucontributetothediversityofourteam? Wearelookingtobuildadiverseteam–diverseintermsofethnicities,cultural backgrounds,hometowns,upbringing,personalities,identitiesandlifeexperiences. 9.Pleasetelluswhyyouthinkparticipationinthisprogramwillhaveabig impactonyourlife. WehopeInspiringGirlsExpeditionswillbealifechangingexperienceforourparticipants. Pleaseprovidespecificexamplesonhowthisprogramwillimpactyourcurrentsituation andinfluenceyourfuturegoalsinlife. 10.HaveyouappliedtoanyInspiringGirlsExpeditionsinpreviousyears? 11.Isthereanythingelseyouwouldlikeustoknowaboutyou? IconfirmthatIwrotethisapplicationmyself,withatmostsomesuggestionsandediting helpfromfamily,teachers,orfriends.IconfirmthatIhaveansweredthequestions honestly.IwillinformInspiringGirlsExpeditionsofanychangesthatmightimpactmy selectionfortheprogram.
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