STEMpowerment Mentee Application
Welcome and thanks for your interest in the STEMpowerment Mentorship Program! If you have any questions about the application or the program in general, please email
Phone Number (Optional)
Are you currently or have you previously been home-schooled? (Optional)
Name of current educational institution
Which languages do you speak fluently?
Do you identify with any of the following groups? (Check all that apply)
None of the above
Which field within STEM are you most interested in?
I am not sure
What do you hope to gain from this program? (100 words max)
Is there anything else you would like us to know about you? (Optional)
This is the end of the application
Thanks for applying, we will get back to you within 5 working days.
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