California
Girls State

Application Pages

The details are important!

Page 1

All lines are to be filled in with information about you, your school, and the Girls State Chairman.

Please try to complete the form on line. If you must fill in the form using your printing - do not print too small!

Page 2

Participant & Parental Acceptance

It is required for you and your parents to read the eligibility requirements, to agree, and then to date and sign at the bottom of the page.

Page 3

Health & Safety

It is required for you and your parents to read about the rules at Girls State, to agree to adhere to these rules, and then to date and sign at the bottom of the page.

Page 4

Medical Certification

All lines are to be filled in. If something does not apply to you and your health, put N/A on the line. Parents and a medical doctor must sign and date this form. The only exception is in the case that you have a current medical exam report in your school file. A copy may be attached since the doctor's signature will be there. There can absolutely be no exceptions!

Page 5

Medical Treatment & Hospital Services

This information is required by the nurse. It gives her the information and consent should an emergency arises which would require you to have professional medical attention.

Some of the information is the same found on Page 4. However, it must be completed since this page is separated from Page 4 to be held in a portable file in case of emergency.

Page 6

Medical Insurance

If your family has health insurance and a card is issued, the front and back of the card must be copied onto this page.

If you do not have insurance, your parents must sign the release which states they agree to be financially responsible in the event medical treatment is required.

Page 7

Bio

Tell your Counselor about yourself. Don't forget a photo.

Page 8

Release for Minors

This form makes it possible for the California Girls State program to take your picture and use it to promote the program.

The Process

There are several levels of review. When missing information is noticed, the entire application will become stalled and you will not be entered into the database.

It is your responsibility to be thorough, check your work, and submit a completed application packet.

Always refer to your Girls State Chairman when you have a question.

Today's Students . . . Tomorrow's Leaders
Girls State is among the most respected educational programs of government instruction for high school students.

Applications

70th Session 2013

Delegate Forms | 1st Alternate Forms | 2nd Aternate Forms

Samsung Scholarship Application (Delegates Only)

Note: All forms and information for Unit use can be found here.

Delegate Application Packet - Packet is in .pdf format. (Free Adobe Acrobat Reader software required.)

Form should completed online except for signatures/dates.
Save and print form. DO NOT PRINT FORMS BACK-TO-BACK (2-sided).
Obtain all signatures and dates.
Submit form to Unit Chairman.

This 8-page form is to be completed by the delegate chosen by the Unit. It includes the Application cover page, Participant and Parental Acceptance, 2013 California Girls State Medical Certification, Consent to Medical Treatment and Hospital Services, Health & Safety, Delegate Biographical Sketch, and Release for Minors.

The delegate, her parent(s) or guardian(s), and a school official are required to complete and sign the application packet before returning it to the Unit Chairman

The delegate must submit the completed application packet to her school official prior to March 1 or as directed by the Unit Chairman.

The school official must submit the completed and signed application packet to the Unit Chairman by March 1 or as directed by the Unit Chairman.

Director Information Packet for Delegates - (May 2013) The Girls State Director is sending each delegate a packet which includes:

A letter to Delegates and Parents
Girls State Basics
What to Bring
Transportation Information - Required to Attend
Arrival Medical Report - Required to Attend
Post Session Pick Up - Required to Attend

Delegates also need the following:

California Girls State Legislation Information
Samsung American Legion Scholarship (if a descendant of a veteran)
DOC Format PDF Format

1st Alternates

To be chosen as an alternate is an honor. In case the delegate is unable to attend, the 1st alternate steps in. California Girls State experiences a significant percentage of 1st alternates attending a session in place of delegates. In order to be eligible to move up to delegate, a completed application must be on file with the Girls State Committee.

1st Alternate Application Packet - Packet is in .pdf format. (Free Adobe Acrobat Reader software required.)

Form should completed online except for signatures/dates.
Save and print form. DO NOT PRINT FORMS BACK-TO-BACK (2-sided).
Obtain all signatures and dates.
Submit form to Unit Chairman.

This 8-page form is to be completed by the 1st alternate chosen by the Unit. It includes the Application cover page, Participant and Parental Acceptance, Health & Safety, 2013 California Girls State Medical Certification, Consent to Medical Treatment and Hospital Services, Delegate Biographical Sketch, and Release for Minors.

The 1st alternate, her parent(s) or guardian(s), and a school official are required to complete and sign the application packet before returning it to the Unit Chairman

The 1st alternate must submit the completed application packet to her school official prior to March 1 or as directed by the Unit Chairman.

The school official must submit the completed and signed application packet to the Unit Chairman by March 1 or as directed by the Unit Chairman.

2nd Alternates

To be chosen as an alternate is an honor. In case the delegate is unable to attend, the 1st alternate steps in. If the 1st alternate is not able to move up, then the 2nd alternate moves up to delegate. California Girls State experiences a significant percentage of 1st or 2nd alternates attending a session in place of delegates. There have been Governors of Girls State who were 2nd alternates. In order to be eligible to move up to delegate, a completed application must be on file with the Girls State Committee.

2nd Alternate Application Packet - Packet is in .pdf format. (Free Adobe Acrobat Reader software required.)

Form should completed online except for signatures/dates.
Save and print form. DO NOT PRINT FORMS BACK-TO-BACK (2-sided).
Obtain all signatures and dates.
Submit form to Unit Chairman.

This 8-page form is to be completed by the 1st alternate chosen by the Unit. It includes the Application cover page, Participant and Parental Acceptance, Health & Safety, 2013 California Girls State Medical Certification, Consent to Medical Treatment and Hospital Services, Delegate Biographical Sketch, and Release for Minors.

The 2nd alternate, her parent(s) or guardian(s), and a school official are required to complete and sign the application packet before returning it to the Unit Chairman

The 2nd alternate must submit the completed application packet to her school official prior to March 1 or as directed by the Unit Chairman.

The school official must submit the completed and signed application packet to the Unit Chairman by March 1 or as directed by the Unit Chairman.