Sign your child up for our mentorship program.  Available for Boys & Girls, Grades 5th thru 8th.
Welcome to our mentorship program interest sheet!  We are excited to learn more about you (or your childs) interests and goals, and to match you with a mentor who can help you achieve them.  Please take a few minutes to answer the following questions so we can get to know you better.  Your responses will be kept confidential and will only be used for the purposes of your mentorship program.  Thank you for your interest!
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Childs Name *
First and last name
Does the child have nickname? Or a preferred name?
What is the birthdate of the child *
MM
/
DD
/
YYYY
What school grade is the child currently in, or passing to (Summer applicants): *
Required
Parents Email *
Parents/Guardians Phone number *
Parents/Guardians mailing address (Address, City, State, Zip Code) *
Is there any specific areas/categories you want your child to learn more about through our mentorship program?  Choose all that apply: *
Required
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