Empower SCI: Peer Mentor Application - Teen Program
Application as a Peer Mentor for the residential summer program hosted at the New England Institute of Technology – East Greenwich Campus.

Consider listing your "personal" email address here instead of a school or business account.  Responses to school and business based emails are occasionally flagged as spam.
Sign in to Google to save your progress. Learn more
Email *
Application Timeline - Teen Program
  • Please complete and submit this form by May 15
  • Notification of acceptance by July 15
  • Staff Training: August 10
  • Program Dates: August 10-17
Caregiver Statement
If you require >3 hours per day of personal care assistance, please arrange caregivers to provide your personal care.  Empower SCI will pay for the room and board for both peer mentor and one personal care assistant.
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Empower Spinal Cord Injury. Report Abuse