All sections of this application must be completed. Parents, please review this application prior to signing.
I, __________________________________________, give my son/daughter permission to participate in the MIPO Mentor/Mentee Program and I hereby agree to all of the above authorizations.
Making the Impossible Possible, Inc.
P.O. Box 360171
Brooklyn, NY
11236-0171
631-954-1920
347-523-2196
www.mipoinc.org
info@mipoinc.org