Mentee Application

Parent/Guardian Information
Parent/Guardian Information *

First NameLast Name
YesNo
Parent/Guardian Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian's Phone Number*
Please, provide phone numberFormat: (000) 000-0000.
Parent/Guardian's Email*
example@example.com
Use Parent/Guardian'sOther Number
Text (use cell phone)Phone CallEmail

Applicant's Interests: Education & Career Goals
YesNo
CollegeVocational SchoolEntrepreneurshipMilitary or similar (navy, air force, etc.)UndecidedI just want to find a job -no other plans
List the name of the college(s) or vocational school(s) that interest you.
What are you career goals? (for example, lawyer, doctor, engineer, mechanic, business owner, scientist, etc.)*
(Tell us about your desired career path - for example, Pediatrician, Programmer, Business Ownership, etc.,)?
Select one or more industries based on your career interests *
If you picked more than 3, rank your top 3.

Applicant Basic Information