New GOTR Site Application

Thank you for your interest in Girls on the Run of Nebraska. If you would like to see a particular school, community center or park host a Girls on the Run team, please complete the short application below.

About You

* You First Name

* Your Last Name

* Your Email Address

* How did you hear about Girls on the Run of Nebraska? If you were referred, please list your referring friend's name and e-mail (if you know it).

Proposed Site Location and Demographics

* School or Site Name for Possible GOTR Team

School District, if applicable

* Address of Potential Site

* City

Zip Code

School/Site Phone Number

* How many registration brochures will you need to distribute one to every girl in grades 3, 4 and 5 (and 6, if applicable)?

* Where will the GOTR team meet indoors in the event of foul weather?

* What is the approximate percentage of free/reduced lunch students at this school? (Check the school website or call the office for this information.)

* Is this school designated Title 1 by the federal government?

* The base tuition rate for GOTR-Nebraska programs is $75, which breaks down to about $4 per hour of participation and includes the 5K entry. Based on your knowledge of this school, will this tuition fee be a hardship for the majority of students there?

* At eligible schools, GOTR-Nebraska will match up to $25 per girl if another organization contributes funding to underwrite tuition. Does this school have an organization (PTO, community learning center, sponsor, e.g.) that will contribute to reduce tuition fees across the board?

Site Contact Person

Please complete the contact information for the person who manages/oversees the proposed site, e.g. school principal, community center manager, parks director.

First Name

Last Name

Position at school/site
(e.g. teacher, parent, volunteer)

Email Address

Phone Number

First Name

Last Name

Position at school/site
(e.g. teacher, parent, volunteer)

Email Address

Phone Number

First Name

Last Name

Position at school/site
(e.g. teacher, parent, volunteer)

Email Address

Phone Number

First Name

Last Name

Position at school/site
(e.g. teacher, parent, volunteer)

Email Address

Phone Number

* Indicates Response Required