Mentee – Level the Playing Field Leadership Academy

Mentee Applications

Step 1 of 2

Mentee Application
Thank you for your interest in becoming a potential mentee at Level the Playing Field Leadership Academy. We know it can be challenging for a single parent/guardian to raise an active young man. We want to partner with YOU…. We are currently accepting fifteen (15) boys into our program for June 2021. Applications will open on May 3, 2021. Please note that we can only accept boys between the ages of 10-13. Boys will participate until the age of 21. They need to be currently enrolled in school and on a football roster for the 2020-21 school year. Please complete the following to move forward:
Potential Level the Playing Field Athlete:
Name*
First Last
Date*
MM slash DD slash YYYY
School and Grade*
Current Grade Level*
Select your current grade level.
Sport*
We are only currently accepting football athletes at this time.
Position*
Race/Ethnicity*
Household information:
Parent/Guardian Name*
First Last
Relationship To Athlete:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Personal Email*
How many siblings live in the home with the student-athlete?*
Does a male (over the age of 18) other than the parent/guardian live in the home with the student-athlete?*
- Yes
- No
Does the student-athlete have transportation to and from Level the Playing Field events?*
- Yes
- No
If not, please provide details on how your son can be transported to and from our events?
Will the student-athlete be able to commit to attending 2 or more Level the Playing the Field Leadership Academy events per month?*
- Yes
- No
Will the parent/guardian be able to commit 4 volunteer hours a month and attend required workshops?*
- Yes
- No

Student-Athlete Questionnaire:
Tell me about yourself (What are your likes, hobbies or interests?):*
Why are you interested in this program?*
What are your academic interests?*
What do you want to be when you grow up?*
Parent/Guardian Questionnaire:
How did you hear about Level the Playing Field?*
Why are you interested in this program?*
Reference
Please list your 3 references. At least one coach is required.
Reference 1 Coach:*
First Last
Phone*
Personal Email*
Reference 2*
First Last
This reference can be a teacher, church leader, mentor, or personal.
Phone*
Personal Email*
Reference 3*
First Last
This reference can be a teacher, church leader, mentor, or personal.
Phone*
Personal Email*

Mentee Applications

Step 1 of 2

Mentee Application

Potential Level the Playing Field Athlete:

Household information:

Student-Athlete Questionnaire:

Parent/Guardian Questionnaire:

Reference