GOTR-Nebraska New Site Application

Thank you for your interest in Girls on the Run of Nebraska. If you would like to offer programming at a particular school, community center, church or other venue, please complete this application.

GOTR-Nebraska offers two seasons based on geographical regions:

* Fall Season runs early September to mid-November and is open only to metro locations (Omaha, Lincoln and suburbs).

* Spring Season runs late February/early March to mid-May is open only to Greater Nebraska locations (Panhandle, Central, Northeast, Southeast).

Please obtain permission to host a team from the school principal or site authority before completing the new site application. THANK YOU!

Please direct your principal to the website for more information -- www.GOTRNebraska.org.

About You

Your First Name *

Your Last Name *

Your Email Address *

Your Phone Number *

How did you learn about Girls on the Run of Nebraska? Check all that apply. *

Proposed Site Location and Demographics

Which geographic region is closest to your proposed site? *

Metro -- Lincoln, Omaha and suburbs

North-Central/Northeast Nebraska

Southeast Nebraska (non-metro east of Grand Island)

Central/Southwest Nebraska -- (west of Grand Island)

Panhandle

Other Other

Name of School or Site *

Site Phone Number *

School District, if applies

Dismissal Time *

County of Site *

Site Address *

City *

State *

Zip Code *

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.) *

Does this school have a SCHOOLWIDE Title 1 designation by the federal government? (Note: Don't answer "yes" if the school has only "targeted" Title 1 status.) *

Some Title 1 schools are eligible for a reduced tuition rate if the school and/or agency (PTO, CLC, community partner) also contributes funding. Does your school have resources, businesses, organizations like the Lions Club or community foundations that will support programming? *

The base tuition rate for Metro GOTR-Nebraska programs is $100 at most non-Title 1 Sites, plus a $50 GOTR 5K package entry fee (covers child and adult Run Buddy). The program tuition breaks down to less than $5 per 75-minute meeting ($4 per hour of activity). Based on your knowledge of this school, will this tuition fee be a hardship for the majority of students there? (Note: GOTR-Nebraska offers financial aid on an individual basis to for those with documented need, e.g. girls on free/reduced lunch program at school or special circumstances.) *

The regular tuition rate for Greater Nebraska (i.e. non-metro) GOTR-Nebraska programs is $65 plus 5K entry fees for GOTR girls and Run Buddies. The program tuition breaks down to less than $3 per hour of activity. Based on your knowledge of this school, will this tuition fee be a hardship for the majority of students there? (Note: GOTR-Nebraska has limited funding to provide individual financial aid for those with documented need, e.g. girls on free/reduced lunch program at school or special circumstances.) *

Based on your knowledge of this school, will this tuition fee be a hardship for the majority of students there?

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.

Site Authority First Name *

Site Authority Last Name *

Principal/Site Authority Email *

Coach Candidates

Please complete the contact information for at least two people at your school who will volunteer to coach. Two coaches are required for a team of up to 15 girls; three coaches are required for a team of up to 20 girls. Coaches must attend training and commit to coaching the entire season (approximately 40 hours over three months for first-time coaches).

Candidate No. 1

First Name

Last Name

Email Address

Phone Number

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

Candidate No. 2

First Name

Last Name

Email Address

Phone Number

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

Candidate No. 3

First Name

Last Name

Email Address

Phone Number

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

Candidate No. 4

First Name

Last Name

Email Address

Phone Number

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

Please be patient after submitting your application. Principals will be contacted to register school for the next appropriate season of programming, which could be several months away.

Fall site registration begins in late March/April. Spring site registration begins in late September/October.