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  • Mentee Application Form

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    Asian Children Mentoring Program
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    This document is an application for parents to enroll their Asian children in a mentor program at the University of Georgia. It requests information such as the names, birthdays, and ethnicity of the children; contact information for the parents; hobbies and interests; the number of mentors requested; preferences for the type of relationship and interaction time; availability to send children to campus; and a signature and date from the parents.

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    This document is an application for parents to enroll their Asian children in a mentor program at the University of Georgia. It requests information such as the names, birthdays, and ethnicity of the children; contact information for the parents; hobbies and interests; the number of mentors requested; preferences for the type of relationship and interaction time; availability to send children to campus; and a signature and date from the parents.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2 views2 pages

    Mentee Application Form

    Uploaded by

    Asian Children Mentoring Program
    This document is an application for parents to enroll their Asian children in a mentor program at the University of Georgia. It requests information such as the names, birthdays, and ethnicity of the children; contact information for the parents; hobbies and interests; the number of mentors requested; preferences for the type of relationship and interaction time; availability to send children to campus; and a signature and date from the parents.

    Copyright:

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    of 2

    UNIVERSITY OF GEORGIA/ATHENS AREA

    ASIAN CHILDREN MENTOR PROGRAM


    Family Partner Application (Please PRINT)

    Name of Parent(s) ______________________________________________________________

    Name(s) of Child(ren) and Ethnicity


    1.___________________________________ 3.__________________________________

    2.___________________________________ 4.__________________________________

    Birthdays of Child(ren): mm/dd/yyyy

    1.___________________________________ 3.__________________________________

    2.___________________________________ 4.__________________________________

    Contact Address ________________________________________________________________

    City _________________________________________ State __________ Zip____________

    Email address_____________________________________ Preference for contact: Day/Night

    Phone ____________________ (H) _____________________ (W)


    _____________________(C)

    Hobbies/Interests _______________________________________________________________

    _____________________________________________________________________________
    _

    Number of mentors requested_________

    Preference for type of relationship with a student mentor(s) (check all that apply)

    ____ Male _____ Female

    ____ Social _____ Cultural ______ Language

    ____ Any Asian ethnicity _______________ Other (specify)

    Available / Possible Interaction Time (check one):

    Weekly: ____ Monthly: ____ Weekends: ____ Other (specify): ________________

    Are you able to send your child to campus? Yes/No

    Additional Comments:
    Signature: ________________________________________ Date: ______________

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