Nominate a Youth Mentor
Do you know a girl(s) and/or femme presenting person of color in grade(s) 9-12 who would like to be a part of a FREE youth-led summer mentorship program where they are given the opportunity to be a leader and earn community service hours by mentoring girls of color in grades 4-8, teaching them self-love practices, leadership skills, career goals, and how to plan a path to college or other post-secondary pathways. Yes? Then fill out this form to nominate them for Rose From Concrete!
Sign in to Google to save your progress. Learn more
Email *
Your Full Name *
Your Role in the Nominee's Life *
Example: Teacher, Administrator, Mentor, Coach, etc.
Nominee's Full Name *
Age of Nominee and Grade *
Example: 12 years old & in 6th grade
Nominee's Contact Information *
Best form of Contact is their email!
Nominee's Parent(s) Contact Information *
Best form of Contact is their email!
Why Do You Believe This Student Should Be In This Program?
The question is optional, but it would be amazing to get some insight on a potential member of the Rose From Concrete sisterhood! Please use this to tell me all about the student, especially what leadership traits they embody!
Would You Like to Nominate Another Student? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Tonya Walls. Report Abuse