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Student Mentor Application 2022-2023
student application
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Email
Your answer
First Name
Your answer
Last Name
Your answer
Student ID #
Your answer
Gender - Your mentor will be of the same gender
Female
Male
Clear selection
Student Cell Phone #
Your answer
Student's PERSONAL email address (non district). Use the email address that you would use to sign up for PSAT
Your answer
Mother/Guardian Name
Your answer
Mother/Guardian Best Contact Phone #
Your answer
Father/Guardian Name
Your answer
Father/Guardian Best Contact Phone #
Your answer
Which Academy are you in?
Entrepreneurship
Cybersecurity
Computer Programming
Clear selection
How many years have you been in the Mentor Program?
This will be my First Year
This will be my 2nd Year
This will be my 3rd year
This will be my 4th year
Clear selection
What is your Mentor's name?
Your answer
List your career interest
Your answer
Describe your interests or personal qualities (hobbies, extra-curricular, academic, career) that will help us place you with a compatible mentor.
Your answer
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