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Girl Glow Subscription

County of Residence
Ethnicity
On a scale of 1-10, how confident do you feel your child is in her abilities?
How would you rate your child's current academic performance?
Below Average
Average
Above Average
How involved is your child in extracurricular activities?
Not involved
Somewhat involved
Very involved
Does your child exhibit leadership qualities?
Never
Sometimes
Often
Always
How would you describe your child's social skills?
Poor
Average
Good
Excellent
How much support does your child receive from family and friends in her personal and academic life?
Minimal
Moderate
Significant
How often would you like to receive period supplies for your child? Once every...?
1 month
3 months
6 months
Once will be fine
Type of Support :
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