Seeds of Wisdom Mentor Program
Mentee Enrollment Application
Students Name
Address
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Parents Name (If under 18)
Parents Email
example@example.com
Phone #
Format: (000) 000-0000.
Household Size
Household Income
Race/Ethnicity
Gender
School Name
Hobbies/Interests
What are you hoping to learn from the program?
Our groups are done virtually with volunteer/social events in person. Do you give permission to Mental Exchange Inc. to use your photograph/image in media publications? ex: social media, promotional flyers.
Yes
No
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