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Mentees Application
To read more about our Q2 Youth Empowerment program, please visit: http://q-ed.org/q2-youth-empowerment/

For an Arabic version of this application, please visit: https://docs.google.com/forms/d/1hZ35VIbzDXRL2yWbVuIdNlPy62uGKP9oKT3UKcAlJfU/

Part A: Contact Information
Full Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Part B: Demographic Data
Age *
Your answer
Gender *
Ethnicity *
Your answer
Home Address *
Please include city.
Your answer
Languages *
Required
Preferable meeting times *
Mentee's must commit a minimum of 2 hours a week for one-on-one session and participate in monthly group activities. The one-on-one sessions between a mentor and mentee are flexible, they could be in person meetings or online interactions. Please specify your availability in terms of DAYS and TIMES you are available.
Your answer
Are you looking for specific trait(s) in a mentor? If yes, please state it/them.
Your answer
Education
School Name *
Your answer
Years Attended *
Your answer
Potential Field of Post-Secondary Study *
Your answer
Part C: Needs Assessment
Why do you like to join a mentorship program? *
Your answer
If anything, state one thing you need guidance with: *
Your answer
State, at least, one thing that troubles you in school: *
Your answer
State, at least, one thing that troubles you at home: *
Your answer
State, at least, one thing that troubles you in the community: *
Your answer
What would you like to get out of the mentorship program? *
Your answer
On a scale from 1 to 5 (5 being most important), how important is it to share the same academic/ career interests with mentor? *
Are there any specific characteristics you would want us to consider in matching you with a mentor? *
Your answer
Who is your role model? *
Your answer
My family and friends describe me as: *
Please tell us about yourself more. What are your hobbies, special interests and previous volunteering experience? *
Your answer
How did you hear about this Mentorship Program? *
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