Student Mentor Program Application - NSITE
Thank you for your interest in the NSITE Mentor Program.  We will do our best to pair you with someone in your field of interest.  Once you complete this application, you will need to print the Student Acceptance of Responsibilities form and return it with a parent signature to Mrs. Noriega in the NSITE Office.  
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First Name *
Last Name *
Student ID# *
Grade *
Gender - Your Mentor will be of the same gender *
T-Shirt Size *
Student Cell Phone # *
Mother/Guardian Name *
Mother/Guardian Best Contact Phone # *
Mother /Guardian Alternate Contatct Phone #
Father /Guardian Name *
Father /Guardian Best Contact Phone #
Father / Guardian Best Alternate Phone #
Which Academy are you in or likely to choose? *
List two fast food meal choices you enjoy; including drink *
List any food allergies or dietary restrictions (if any) that your mentor should know about when purchasing food *
How many years have you been in the Mentor Program? *
If you are a returning mentee, what was your Mentor's name? *
Would you like to stay with that mentor? *
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