Missouri Girls State Application

Name Information

First Name *

Middle Name

Last Name *

Preferred Name

Contact Information

Email Address * (non-school email address)

Mobile Number

Mailing Address *

Country

Street

City

Region

Postal Code

Demographics

Birthdate *

Gender Identity

Primary Citizenship *

Program of Study

Educational Information

High School Attending *

Anticipated Graduation Date *

DeleteParent _ID_
Parent Information
Relationship Type * Parent First Name * Parent Last Name * Parent Email * Would you consider this person to be your Emergency Contact? * Parent Phone * Parent Phone

Add Additional Parent

After you submit, you will be asked for additional Event specific questions. Please submit this information as well.

By submitting this application, you are giving your express written consent for Lindenwood University to enroll you in PS19001 Summer Workshop in State and Local Governments, a zero credit hour course for the summer term. A passing grade on the exam, active participation in the week’s activities, compliance of rules and regulations, and attendance for the entire session will enable a citizen to apply for college credit. More information on the college credit will be available prior to the session’s start date.

Additionally, by submitting this application, you are giving your express written consent for Lindenwood University and its partners to contact you regarding our educational programs and services using email, telephone or text - including our use of automated technology for calls and periodic texts to the wireless number you provide. Message and data rates may apply. This consent is not required to purchase goods or services and you may always email us directly, including to opt out, at admissions@lindenwood.edu.