Mentoring Program Application Form
Student's Name
First Name
Last Name
Date of Birth
Ex: 00/00/0000
Student Current Grade
Student's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent Name
First Name
Last Name
Parent's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent's Email
example@example.com
Current School
Current Cumulative GPA
Most Recent Marking Period Grades
Is the student's goal to go to college?
Yes
Not
Not really sure yet
Thinking about other options
Is the student interested in being apart of our travel basketball team?
Yes
No
Are you interested in being apart of our program even if you are not selected to be apart of our travel basketball team?
Yes absolutely!
No not really
Are you involved in any other extra-cirricular activites?
Yes
No
F.A.M. meets weekly on Sundays (1:45pm-5pm) would you be able to commit to attending program every Sunday?
Yes, not a problem
Not really sure
What are 3 life goals that currently have?
Submit
Should be Empty: