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Mentorship Application
Complete the form to apply for Mentorship at Liberty High School
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* Indicates required question
Select the Class you would like to apply for
*
Mentorship I ONLY
Mentorship I & II
Service Learning
First Name
*
Your answer
Last Name
*
Your answer
Grade at the start of the 2023-2024 school year
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11th
12th
Required
What is your current cumulative GPA?
*
Your answer
Short writing prompt: What are your plans for the future/your future goals? What skills do you currently have that will help you achieve your goals? What skills do you still need to develop?
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Your answer
Short writing prompt: Describe yourself in three words. What are your strengths? How would your friends describe you?
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Your answer
Identify 2 teachers that will serve as a reference/recommendation for you. We will contact these teachers, you do not need to.
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Your answer
Do you currently have a driver's license?
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Yes
No
Do you currently have a car?
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Yes
No
You are required to provide your own transportation for this course. Please describe how you plan to do that if you do NOT have a license or car.
*
Your answer
How did you hear about this/these courses?
*
My Guidance Counselor
Friend(s)
My Parents
A Teacher
Homebase
Course Offerings book
Other:
Parent/Guardians Names
*
Your answer
Parent/Guardian Preferred phone number
*
Your answer
parent/guardian email
*
Your answer
student email
*
Your answer
1st period teacher
*
Your answer
2nd period teacher
*
Your answer
3rd period teacher
*
Your answer
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