Welcome to Brothers in Grace Mentoring
We are very glad to know you are interested in participating in mentoring young men. Please carefully read this application. Make sure the information you provide is complete and accurate. Also, please do not leave any blank space. If you have any question/issue, do not hesitate to reach us at brothersingraceorg@gmail.com. We look forward to seeing you !
Full Name
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First Name
Last Name
Email
example@example.com
Birthdate
*
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Day
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Month
Year
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Mobile Number
*
Parent/ Guardian Name
School Name
Current Address (Brothers in Grace will mail you the membership welcome bag)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your current employment situation and do you have any additional training, certification or skills that may be useful in our camp setting?
When participating in Brothers in Grace activities (I or the person I'm registering) gives consent to be interviewed, photographed, videotaped, or electronically imaged for the purposes of the betterment of the program for promotional materials, news releases, or other published formats. By signing, you hereby release and hold harmless Brothers in Grace from any claim arising from the use of these images. We will only use your personal, familiar, and educational information for application purpose. Your information will be confidential in our office. Also, be sure that once you submit this Application Form you will not be able to do any changes or remove any information. You confirm to be submitting only truth information, otherwise your Application might be canceled and you will not be able to be admitted for the Brothers in Grace Mentoring Program *
Yes
No
Signature
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