Planet Gyrl
Mentee Application
planetgyrl@gmail.com
IG: _planetgyrl
mentee application Form
Please answer every question. Remember-be yourself!
Full Name
*
First Name
Last Name
DOB
*
Date of Birth
Age
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
How did you hear about Planet Gyrl?
*
Please Select
Instagram
Facebook
Friend
Other
Please Specify
*
What kind of person would you like your mentor to be? (A good listener, active in sports, etc.)
*
What are three words that would best describe your character strengths?
*
Is there anything that you would change about yourself?
*
What clubs, activities, or sports are you in now? How much of your time do these activities take up?
*
Will you try your best to meet with the program once a month and to notify a leader if you are unable to attend?
*
Yes
No
Will you try your best to attend every meeting with a positive attitude?
Yes
No
Mentee Signature
*
Electronic Signature
Date
Back
Next
Parent/Guardian Permission Letter
Dear Parent/Guardian, Your daughter has an interest to participate in the Planet Gyrl Mentor Program. Volunteers from the community between the ages of 21-35 will serve as mentors to the young girls in this program. The mentors have been thoroughly screened. The goal of the program is to improve self-esteem, academic performance, and positive emotional development. Sessions take place on Saturdays from 12:00pm – 1:30pm. Location to be provided in advance. In order for your child to participate, please complete the bottom portion of this form.
Parent/Guardian Contact Form
*
Full Name
Relationship
Contact Number
Contact Email Address
1
Do you also give permission for your child's picture and/or quotes to be used for educational purposes and/or for promotion of Planet Gyrl?
*
Yes
No
Parent/Guardian Signature
*
Electronic Signature
Date
Submit
Should be Empty: