RCIGF Mentee Application

Mentee Application

Where young people can ROAR Rising Opportunities, Ambitions Realized. Thank you for your interest in joining Robby Coachman Impact Generation Foundation Mentorship Program. This questionnaire is for both Mentee and Parent or Guardian. Please take a few minutes to complete this form to help us understand how we can best serve you and your youth. It is our goal to match your youth with a mentor suitable for their need.
Your Name*

First NameLast Name
Parent/Guardian Name (if under 18)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Preferred contact method (Phone/Text/Email) Best Time/Day*
example@example.com
Favorite color, sport, music or activity*
example@example.com
T-shirt size: Small, Medium, Large, XLarge, 1XL, 2XL, 3XL *
example@example.com
Phone Number*
Do you need accommodations to participate in the mentorship program?*

YesNo
Please enter what type of accommodation services do you need.*
Emergency Contacts*
Education Level*
School Name*
Life/Career Interest*
Birthdate*

MonthDayYear
Date
How did you find this mentorship program?*
Personal/Professional Development Interest*

Availability Information: How many hours per week/month can you commit to the Coachmentoring Movement program?*

Are you available for in-person meetings, virtual meetings or both?*
What are your personal goals for the next 3 months? List your long-term goals (3-5 years life/career aspirations? Why do you want to join the Robby Coachman Impact Generation Foundation mentorship program? *
Please tell us your extracurricular activities, church, clubs, volunteering experiences you are involved in.*
Parent or Guardian Questions: Preferred Method of Support to participate in our Parent-Guardian Connect Circle In-Person, Virtual or both. What days/time is best for you? *
Additional Comments or Specific needs for your youth *
i.e. Tutoring, Life Skills, Career Development
Photographic & Volunteer Release

I hereby acknowledge that the information given above is accurate and I give permission to the Robby Coachman Impact Generation Foundtion for the use of my photographs that are taken by staff in order to use for social media.

Consent and Agreement
I consent to my child participating in the mentorship programs and activities provided by the Robby Coachman Impact Generation Foundation.
Volunteer Mentee Signature*

Clear
Parent/Guardian of Mentee Signature*

Clear
Should be Empty: