Mentee Application

Parent/Guardian
Parent/Guardian Information *

First Name Last Name
Is your Address the same as the applicant's?

Yes No
Parent/Guardian Address

Street Address

Street Address Line 2

City State

Zip Code
Parent/Guardian Phone Number *
Please, provide phone number
Parent/Guardian Email *
example@example.com
Emergency Contact Phone Number *

Use Parent/Guardian's Other Number
Parent Preferred Communication *

Work Phone Text (use cell phone) Cell Phone Email

Interests: Education/Career
Have you attended middle school in the U.S? *

Yes No
What are you post high school goals? *

College Vocational School Entrepreneurship Military or similar (navy, air force, etc.) Undecided I just want to find a job -no other plans
If you know the colleges or schools you would like to attend, list them.
Tell us about your professional or career goals *
(Tell us about your desired career path - for example, Pediatrician, Programmer, Business Ownership, etc.,)?
Select one or more industries based on your career interests *
Rank your top 3 industries, if you selected more than 3

Applicant Basic Information