iShapeMe Mentor Application

iShapeMe Mentor Application

Spring 2025 Session
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Race/Ethnicity:*

Asian/Pacific IslanderBlack (including African or Afro-Caribbean)Hispanic or LatinxIndigenous (including American Indian and/or Native)Middle Eastern or North AfricanWhite/Caucasian
Are you bilingual or multilingual?*
I am a...*

College StudentYoung Professional
If you're a college student, what is your classification?
College or Grad Students – Please share your major/minor.
Young Professionals – Where did you graduate from?
Young Professionals – Please share your industry, field of work and/or place of employment.
This information is used to complete a more seamless background check to ensure the safety of our participants.
Which Circle(s) would you like to serve as a mentor for?*

Simpsonville – Mondays from 4-5:30 PM at Reedy Fork Baptist ChurchGreenville – Tuesdays from 4-5:30 PM at Pleasant Valley ConnectionGreer – Wednesdays from 6-7:30 PM at Needmore Center
T-Shirt Size*
What experiences have you had the will enhance your ability to connect with middle school aged girls from various backgrounds?*
How did you hear about us?*

Email/NewsletterFacebookInstagramTikTokFamily or FriendChurch Bulletin/Announcement
Instagram Handle:
TikTok Handle:
Upload Drivers License (PDF Preferred)*

Each facility runs a background check to ensure the safety of participants.
Cancelof
Should be Empty: