The Beauty In Her Mentorship Application
Thank you for your interest in The Beauty In Her Mentorship Program. This program is currently offered as a virtual group mentorship experience designed to provide women and girls with guidance, encouragement, leadership development, and support as they grow in confidence, purpose, and personal development.Please complete all relevant sections.
Applicant Information
First Name
*
Enter the applicant's first name
Last Name
*
Enter the applicant's last name
City
*
Enter the applicant's city
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Applicant
*
Enter the relationship to the applicant
Does the parent/guardian give permission for the applicant to participate in The Beauty In Her Mentorship Program?
*
Yes
No
Are you applying for yourself or on behalf of someone else?
*
Myself
My daughter/child
A student
Someone else
Is the applicant under 18 years old?
*
Yes
No
Parent/Guardian Information
Please complete for applicants under 18
Parent/Guardian Full Name
First Name
Last Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Mentorship Interest
Which areas are you most interested in?
*
Confidence & Self-Esteem
Leadership Development
Career Readiness
College Preparation
Entrepreneurship
Financial Literacy
Life Skills
Faith & Purpose
Emotional Wellness
Healthy Relationships
Goal Setting
Other
What are 1–3 goals you would like to work toward during mentorship?
*
What challenges are you currently facing that you would like support with?
*
The Beauty In Her Mentorship Program is currently offered as a virtual group mentorship experience.
I understand that this mentorship program is currently offered virtually in a group setting.
*
I understand
Which days are you generally available for virtual group mentorship sessions?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Which times are you generally available?
*
Morning
Afternoon
Evening
How often can you participate?
*
Weekly
Bi-weekly
Monthly
Not sure yet
Can you access Zoom, Google Meet, or another online meeting platform?
*
Yes
No
I may need support
Do you have reliable internet access?
*
Yes
No
Sometimes
Agreements
*
I understand submitting this application does not guarantee acceptance.
I understand The Beauty In Her may contact me or my parent/guardian for more information.
I agree to participate respectfully and honor program expectations if accepted.
I understand mentorship is not counseling, therapy, legal advice, or medical care.
I understand parent/guardian consent is required for applicants under 18.
Is there anything else you would like us to know?
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Agreements & Consent
Signature (Applicant or Parent/Guardian)
*
Submit Application
Submit Application
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