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Nourishing Hands Inc - Participant Application
Welcome to Nourishing Hands Inc - Mentoring Program 2022-2023 Application! We are excited to know you are interested in participating in our program and becoming a leader of our future. Please carefully read this application. Make sure the information you provide is complete and accurate. If you have any questions/issues, do not hesitate to reach us at
info@nourishinghandsinc.org
. We look forward to having you onboard!
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Email
*
Your email
Personal Information
First Name
*
Your answer
Middle Name
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Birth Date
*
MM
/
DD
/
YYYY
Mobile Number
*
Your answer
Street Address
*
Your answer
Street Address Line 2
Your answer
City
*
Your answer
State
*
Your answer
Postal / Zip Code
*
Your answer
Education
School Name
*
Your answer
School Address
*
Your answer
Current Grade
*
Choose
9th grade
10th grade
11th grade
12th grade
College Freshman
College Sophomore
College Junior
College Senior
Have you ever applied to Nourishing Hands Mentoring Program?
*
Yes
No
Are you participating in any other mentoring program? If yes, which one?
100 Black Men Of America
100 Black Women of America
Youth Groups in your community
Youth group at church
Other:
Favorite subject
*
Example: Algebra
Your answer
Favorite teacher
Example: my History teacher
Your answer
What career would you like to pursue as an adult?
Your answer
Career Areas of Interest
*
Arts
Legal
Medical
STEM
Vocational (EX: real estate, financial sales)
Required
Current grade point average (GPA)
Example: 2.5
Your answer
Extracurricular Activities
Activity 1: Name of the activity
Your answer
Activity 1: Years of participation
Your answer
Activity 1: Description
Your answer
Activity 2: Name of the activity
Your answer
Activity 2: Years of participation
Your answer
Activity 2: Description
Your answer
Achievements
List 5 (five) of your most meaningful achievements (awards, merits, scholarships, etc) you have gotten through your high school years. Please specify the name of the project/award, date, organization, and where it took place.
Your answer
Hobbies / Interests
*
Acting
Bowling
Cooking
Dancing
Debating
Decorating
Finance
Football
Gardening
Gymnastics
Hairstyling
Instrument(s)
Music
Organizing & Publicity
Painting
Photography
Running
Singing
Swimming
Table Tennis
Travel
Volleyball
Woodwork/Carving
Other:
Required
Short Questions
In the short questions section, tell us a little bit about yourself and all of the great things that you can contribute to Nourishing Hands and the world.
In no more than 150 words, explain why you want to participate in the Nourishing Hands Mentoring Program
*
Be honest. Be concise. Be yourself.
Your answer
Why do you believe participating in the Nourishing Hands Mentoring program will help you achieve your future goals?
*
Be honest. Be concise. Be yourself.
Your answer
There are so many problems in the world today. If you were asked to solve one problem, what would it be and why?
*
Be honest. Be concise. Be yourself.
Your answer
Essay
Essays are the opportunity for you to differ yourself from others and shine. Be direct, descriptive, and creative. This is your time! You are about to write one essay: one Personal Statement, the prompt is the same for all applicants. Your Personal Statement is very important for us to better understand who you are. Please write your Personal Statement in no less than 250 words and no more than 650 words and based on the prompt below:
Personal Statement Prompt: Describe the world/environment that you grew up in and explain how it has shaped who you are.
*
Your answer
Recommendation Letter
Please email your recommendation letter to
info@nourishinghandsinc.org
Parent Information
Please fill out this section by providing your parent or guardian's information. Please provide accurate information as this will also serve as your emergency contact.
Your parents are:
Married
Divorced
Never married
Clear selection
Parent/Guardian Full Name
Your answer
Parent/Guardian Phone Number
Your answer
Parent/Guardian Email
Your answer
Parent/Guardian Signature
By typing your full name, you grant permission for your child to participate in the Nourishing Hands Program.
Your answer
How many people live in your house, including you?
Your answer
Submission
Is there any other information that you would like to share with us?
Your answer
Did you have any problems while filling out this form? If so, please report it below.
Your answer
Do you agree to submit to us your personal, family, and educational information and are aware that your information will ONLY be used for the purpose of Nourishing Hands Services. You agree to share this information, to complete this application with your parent or guardian, and to receive their consent in order to participate in this program.
*
Yes, I agree
Required
A copy of your responses will be emailed to the address you provided.
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