Language
English (US)
Chinese
Contact Information
Name
*
First Name
Last Name
Preferred Name
Email Address
*
Phone Number
*
Contact Preference
*
Email
Phone Call
Text Message
About You
Please answer the following questions thoughtfully. We will use your responses to match you with a compatible mentor.
Date of Birth
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/
Month
/
Day
Year
Gender
Female
Male
Non-binary
Prefer not to answer
Other
What is the zip code of the town you reside in?
*
What is your language preference? (Check all that apply)
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English
Cantonese Chinese
Mandarin Chinese
Other
Current School Name
*
Grade Starting Fall 2025
*
Junior
Senior
Other
Are you a first-generation college student?
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Yes
No
Prefer not to answer
I would describe myself as... (List at least three traits)
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What are your interests or hobbies?
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What options are you considering for immediately after secondary school/high school?
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4-year college/Bachelor's degree
2-year college/Associate's degree
Community college
Gap year
Work
Trade/vocational school
Apprenticeship/internship
Not sure
Other
What would you like to study in college? (If you don't know, please list out your interests.)
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Which colleges are you interested in? Please list at least 3 colleges. If you are not sure, you can put N/A.
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Aside from CAPS, is there anyone who helps you with the college application process? For example, a guidance counselor, Bottom Line, Upward Bound, a teacher, etc. If YES, please write down their name(s) and their relationship to you.
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What do you look for in a mentor?
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Rank the following factors from the MOST to the LEAST important to you when looking for a mentor: age, gender, personality, career/major, prior experiences/background, and hobbies/interests.
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Is there anything else that you would like to say that may help us find the best mentor for you?
Which location, Boston or Quincy, is more convenient for you to participate in CAPS programming? (Check all that apply)
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Boston Location (38 Ash St. Boston, 3rd floor, MA 02111)
Quincy Location (1458 Hancock St., 2nd floor, Quincy, MA 02169)
What day of the week would you be available to participate in our programming? Programming typically takes place after school. Select all that applies.
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Monday
Tuesday
Wednesday
Thursday
Friday
Have you joined BCNC before?
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Yes
No
Other services at BCNC
What other services are you interested in? Please select all that apply.
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Adult Education (English classes, customer service training program, citizenship classes)
Child Care (ages of 3 months to 13 years)
Community Resources (public benefits, legal consultation referral, and recreational activities or family wellness activities)
Family Support (parenting classes, special needs and public-school systems, infants, and new mothers)
Mental Health Support
Youth Programs College Access and Youth Leadership Program (ages of 13-18)
Youth Job Opportunities (ages of 14-24)
How did you hear about us?
*
BCNC website
Google
Family/friends
Community event/ Job fair
Schools / other community-based organizations
Other
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