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Adulting!? Mentee Application

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Start

Are you under the age of 18 ?

We can only move forward with your application once we have contacted your parent or guardian, so please ensure you provide valid parent/guardian contact information.

Question 2 of 28

Parent/Guardian Full Name

Question 3 of 28

Parent/Guardian Email

Question 4 of 28

Parent/Guardian Phone

Question 5 of 28

Does your household have access to a reliable internet connection?

A

Yes

B

No

Mentee

Information

Question 7 of 28

Full Name

Question 8 of 28

Gender

A

Male

B

Female

Question 9 of 28

Age

Question 10 of 28

Date of Birth

Question 11 of 28

Email

Question 12 of 28

Phone #

Question 13 of 28

Address

Question 14 of 28

City/State/ZIP

Question 15 of 28

Education Level and Current School  

Question 16 of 28

Race/Ethnicity

Interests and Goals

Interests and Goals

Question 18 of 28

What are your interests and hobbies?

Question 19 of 28

Why are you interested in joining the WTFMA mentoring program?

Question 20 of 28

What are your personal or professional goals?

Availability

Availability

Question 22 of 28

Are you available to attend the weekly group call at 5p CST ?

A

Yes

B

No

Question 23 of 28

Are you available for meetings and activities at our resource center at 1800 N 25th St, East St Louis, IL 62204 ?

A

Yes

B

No

Question 24 of 28

Preferred Days/Times for Participation

Additional Info

Additional Info

Question 26 of 28

What do you hope to gain from this mentoring experience?

Question 27 of 28

Any specific skills or areas you'd like to develop?

Question 28 of 28

I confirm that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information could affect my eligibility

A

Yes

Confirm and Submit