Forms

Mentee Application

Mentee Aplication

Interested in a mentor? we offer both Spanish and English speaking mentors. Please fill out this form to be on your way.

Date:
Name:
Birthday:
Address:
City
State:
Zip Code
Home Phone Number
Cell Phone Number
Grade:
School:
Parent/ Guardian Name:
Phone Number
Email Address
How do you prefer to receive news from Teenlite Inc. regarding upcoming events and other important information?

Phone Call
Email
Both
How did you hear about Teen Mentor Program? Select a choice
*
why do you want a mentor? ( Tutoring, advice, friendship, "big brother/big Sister" , college life or hang out partner)
What kind of person would you like your mentor to be? ( A good listener, active in sports, etc.)
What are three words that would best describe you?
Describe three things that you are good at.
Is there anything that you would change about yourself?
What clubs, activities, or sports are you involved in right now?
What kind of acrivities would you like to do with the Teen Mentor Program?
Is there anything else that you would like to describe about yourself that may help us find the best mentor for you?
Emergency Contact Name
Phone Number
Email Address
I acknowledge that after completion of this form, before my application is considered accepted, I will print and have my parent sign the parent/ Guardian Consent and Liability Release Form and turn it in to the appropriate official at my first Orientation.
*

I agree
I do not agree