Skooled

Skoolednewark.com
skoolednewark@gmailcom
Program Founder Monica Hall
President Elizabeth Ojugo
862-438-3391 (founder)
732-484-0812 (president)

Skooled Application
Student Information
Name: _________________________________

Address: __________________________________

Cell Phone Number: ______________________

Home Phone Number: _______________________

Email Address: __________________________

School: ___________________________________

Year of Graduation: ______________________

Academy: _________________________________

Last year cumulative GPA: _________________

What groups or clubs are you also apart of? ______________________________________________________
How did you learn about the Skooled Mentoring program? __________________________________________
Are you also interested in our scholarship opportunities or paid summer program? _______________________
What is your strongest subject? ________________________________________________________________
What is your weakest subject? _________________________________________________________________
Do you need tutoring in a particular subject? _____________________________________________________
What College(s) do you want to attend and what would you like to major in? (At least 1 college/university & 1 major or field of study)
__________________________________________________________________________________________
What are your career goals? ___________________________________________________________________
Do you have a personal statement? Please circle: Yes

No

Do you have a resume? Please circle: Yes

Partial

No

Partial

Do you have a job or internship? _______________________________________________________________

Parent information
Parent/Guardian Names: _____________________________________________________________________
Address if different from above: _______________________________________________________________
Cell phone Number:______________________

Email Address: ___________________________________

I consent to _______________s participation in the Skooled mentoring and tutoring program every Friday that
school is in session from 4pm-6pm. I also consent to occasional pictures being used for the Skooled website
and social media pages: www.skoolednewark.com, www.facebook.com/skoolednewark, @skoolednewark on
Instagram and Twitter. I understand that only positive images depicting the mentoring program will be used and
shown to students before they are uploaded.

Parent signature:__________________________________