Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Thank you for your interest in joining our organization as a mentee! As a mentee, you will have the opportunity to receive guidance, inspiration, and support from a dedicated mentor who will help you navigate academic challenges, personal growth, and future career opportunities. This experience will provide you with encouragement, valuable life skills, and a strong support system to help you achieve your goals.Today's DateYouth's Name *FirstLastDate of Birth *AgeCell Phone *Race *AsianBlack or African-AmericanHispanic or LatinoNative American or Alaska NativeWhiteNative Hawaiian or Other Pacific IslanderOtherPrefer not to sayName of School *GradeParent / Guardian's Name *FirstLastRelationship to Youth *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Home Phone *Cell Phone *Work Phone *Emergency Contact *FirstLastEmergency Contact's Phone Number *Participation in this program means you have a desire to achieve post-secondary success after high school and are ready to make a commitment to the FAM Mentoring Program, by taking your academic studies and community service activities seriously. Please state three (3) reasons for why you should be selected for this program. *What skills or qualities make you a good mentee? *How would your friends and family describe you? *What profession do you want to be when you're older? *If you could change 3 things about yourself, what would they be? *What is the hardest part of school right now? *What are areas of interest that you want to learn more about? * you What Name What are the qualities that make a good friend? *What are your strengths at home, school & in the community? *What are your weaknesses at home, school & in the community? *What kind of music do you listen to? *What is your favorite book/movie? *Submit
