MasterMinds Mentoring Program Interest Form

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Thank you for your interest in your child participating in our mentoring program. You will receive more information about the program and interest meeting once you complete the form via email.

This program is for males and females ages 8-14. In the future, we will open our high school chapter of our program. However, anyone over the age 14 can participate by volunteering at our program sessions to help set up, breakdown and assist with administration duties.

**Please note** This is only the interest form. There will be a full application to complete once you attend the Virtual Interest Meeting in January 2023.

Participants' Full Name *

Participants' Age / Grade *

Participants' Address ( will need correct address to send welcome package) *

Parent/Guardian Full Name *

Parent/Guardian Phone Number *

Parent/Guardian Email address *

Do your child have reliable transportation to attend our sessions? **Some transportation will be provided for our volunteer opportunities outings.**

Yes

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Any additional questions & comments, you can ask here.

Submit

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