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EK Mentoring Application (Summer 2021)
Please supply the following introductory information, and we'll contact you to schedule the initial parent/guardian consultation. (Application Deadline: May 24, 2021)
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* Indicates required question
Email
*
Your email
Parent/Guardian Name(s)
*
First and last name
Your answer
Parent/Guardian Phone number
*
Your answer
Student Name + Age and 2021-22 Grade Level (Please submit separate applications for each child if applying for more than one.)
*
Your answer
Please choose your top two priorities for the student's mentoring session.
*
Thinking: Analytical & Creative
Communication: Written & Verbal
Confidence: Empowerment, Accountability & Autonomy
Other:
Required
Briefly, what interests you most about this mentoring opportunity for your student?
*
Your answer
Any Burning Questions you want us to be sure to cover in your consultation?
Your answer
Did someone refer you? (If, yes, who?)
*
Yes
No
Other:
A copy of your responses will be emailed to the address you provided.
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