Be a Mentee

Potential Mentee & Parent/Guardian Questionnaire:
How did you hear about Level the Playing Field? (parent/guardian response)*
Tell me about yourself (potential mentee response): What are some of your likes, hobbies or interests?*
Why are you interested in this program? (potential mentee response)*
Why are you interested in this program? (parent/guardian response)*
What are your academic interests? (potential mentee response)*
What do you want to be when you grow up? (potential mentee response)*
References
3 references are required for the application. Please list your 3 references and refer to link form below (at least one must be a teacher or principal):
Teacher/Principal (required):*

Full Name
Email Address:*
Phone Number:*
Reference Number 2 (teacher, church leader, mentor, or personal)

Full Name
Email Address:*
Phone Number:*
Reference Number 3 (teacher, church leader, mentor, or personal)*

Full Name
Email Address:*
Phone Number:*

Mentee Application