Language
English (US)
General Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Mailing Address
*
Address Line 1
Address Line 2
*
City
*
Postal / Zip Code
*
State / Province
Date of Birth
/
Year
/
Month
Day
Date
Preferred pronoun
*
Studies and Extra-Curricular Activities
Let us know more about you so we have a better idea what you are looking for
Current School
*
Graduation Year
*
Year that you expect to graduate from High School or College
Current Classes (please note any honors, AP, IB or similar)
Current GPA (if known)
Primary extra-curricular activities and any positions held
*
Describe a meaningful summer or extra-curricular experience. You can also talk about an independent project or other activity that you were really energized by. This does not need to relate directly to the mentorship topic - we are just looking to better understand some of your interests and what you find exciting.
*
In a few words, what are your primary interest area(s) for a mentorship?
*
What are you looking to study with a mentor and how did you become interested in this area? If you have multiple areas of interest and you aren’t sure which one to pursue with a mentor, please feel free to write about each interest separately.
*
Anything else we should know about your interests, learning style or skills you are interested in acquiring that would help us match you with an appropriate mentor?
Please attach a copy of your transcript or most recent report card
Add File(s)
Cancel
of
Have you ever been expelled or suspended? (If yes, please explain)
*
Additional Information
Parent Contact Information
*
Our program typically runs over the summer semester or a 6 month period during the school year. Please tell us when you are interested in starting:
*
Spring 2020
Summer 2020
Other
Please tell us about your availability during the mentorship term and any other commitments so that we can plan appropriately:
To what extent would you agree or disagree with the following statements.
*
Strongly Disagree
Disagree
Agree
Strongly Agree
I have a sense of what I love doing
I have a sense of what I am good at
I have goals for what I would like to accomplish in the future
I have a good sense of the different steps I need to take to achieve my goals
I have a sense of how I can contribute to the world through my own abilities
In this section, you will be asked to consider a variety of possible benefits you may gain from your mentoring experience. Please indicate to what extent these are important to you.
*
Extremely Unimportant
Unimportant
Important
Extremely Important
Clarification of which academic areas interest you
Clarification of a career path
Readiness for college level work
Increased academic self-confidence
Learning to work independently
Please indicate to what extent these possible benefits are important to you.
*
Extremely Unimportant
Unimportant
Important
Extremely Important
Gaining research skills
Gaining organizational skills
Gaining technical skills
Enhancement of your ability to problem solve
Appreciation for the value of your own contributions
Accomplishing a personal goal
Opportunity to work one-on-one with an expert in a field of interest to you
Opportunity to work on a project of your choosing
Please tell us how you learned about Hugo:
*
Save
Submit
Should be Empty: