2019 - 2020 Application: IAM Mentoring for High School Students
Thank  you for your interest in the IAM Mentoring for High School Students program. Please complete the below application before October 1, 2019. Our first day of program is on Tuesday, October 22. Sessions are held on Tuesdays from 5:30PM - 7:30PM until May 18, 2020. All applicants and their parents will be notified via email prior to that date about their participation in the program.

Selected students will be invited to attend a mandatory orientation with their parents on either October 8th or 15th.

Accepted students will pay a one-time registration fee of $200 which will cover all program expenses for the year including dinner each session, field trips and an IAM T-Shirt. The first half of this payment is due on the day of the student's orientation. The balance must be paid by January 21, 2020 for student to complete the program year.

Returning students are required to complete this application as well.

If you have any questions, please email fharris@influencingaction.org.
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Are you a returning student or new student? *
Student First Name *
Student Last Name *
Student Phone Number *
Student Email Address *
Grade *
School currently attending *
Mailing Address *
Street portion only. Example: 30 S. 15th Street
City *
Please write out full names. Example: Philadelphia
State *
Use initial. Example: PA
Zip Code *
Parent/Guardian Name *
Who should be copied on emails about the program?
Parent/Guardian Email Address *
Who should be copied on emails about the program?
Parent/Guardian Phone Number *
We will call your guardian to discuss the program application and seek approval for your participation.
Majority of program sessions are held at Temple University main campus, do you have reliable transportation to get to this location? *
Majority of session are held on Tuesdays from 5:30PM - 7:30PM, will being on time and staying for the session be a challenge? *
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