LeadUS Mentoring Program 2015-16

Welcome ELEV8 Mentee! We are very glad to know you are interested in our mentoring program and are excited to assist you in accomplishing your dreams. Please carefully read this application. Make sure the information you provide is complete and accurate. Also, please do not leave any blank spaces. If you have any questions or issues, do not hesitate to reach us at elev8umentoringprogram@gmail.com

We look forward to helping you ELEV8!

Student Personal Information
Name *

First NameMiddle NameLast Name
Gender*

MaleFemale
Race*

WhiteBlack, Brown, or African AmericanHispanic or LatinoNative American or American IndianAsian or Pacific IslanderOther
Birth Date*
MM/DD/YYYY
Mobile Number*

Area CodePhone Number
Email*
Instagram Profile
Twitter Profile
Facebook Profile
LinkedIN Profile

Student Education
School Name*
School Phone Number

Area CodePhone Number
School Counselor*
Academic Classification*

FreshmanSophomoreJuniorSenior
Current grade point average (GPA)
Class Rank (if applicable)
Have you ever taken any English Proficiency test? (Ex: TOEFL, TELP, etc)? If yes, which one?
Have you taken the SAT?

YesNo
Test Score
Have you taken the ACT?

YesNo
Test Score

Extracurricular Activities
Name of the activity, years of particpation, and provide a brief description
Activity 1
Activity 2
Activity 3
Activity 4
Activity 5
List 5 of your most meaningful achivements (awards, merits, scholarships, etc) you've been awarded through your High School years.
Achievements
If other or not a current athlete please specify below
Other Hobbies/ Interests

ELEV8 Mentee Personal Statement
Essays are an opportunity for you to differentiate yourself from others. Be direct, descriptive, and creative. This is your time...shine!

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Your personal statement is important for us to better understand who you are.

Personal Statement Prompt: Describe the environment you come from and how it has shaped who you are today. Provide additional insight on who you are as a person, your goals, and how you intend on accomplishing them.
Personal Statement*

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By signing this form you agree that all information provided is valid and that you agree to knowing that the information provided by you will only be used for by ELEV8 U Inc.
Signature*

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