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Motor City Mentors- Mentee Application Form
Thank you for your interest in applying to be mentored through our program! Before you fill out this
application, review the information on the "About Our Mentor Program" to learn a little about us. Then,
you can fill out the information below and we will follow up with you soon. Please understand that filling out an application doesn't guarantee that you will be able to participate in the program and that even eligible applicants may have to be placed on a waiting list until we have a mentor that would be a good fit for you. We are excited about getting to know you!
Please tell us about yourself
Name *
First and last name
Address *
Street Address, City, State, Zip Code
Email *
Phone number *
Date of Birth *
MM
/
DD
/
YYYY
Race/Ethnicity *
Languages Spoken *
Languages Spoken *
Your Interest
Tell us more about why you are interested in our program & what you hope to get out of it
Why would you like to have a mentor? *
What goals do you have that you would like your mentor to support you with? *
What types of activities would you like to do with your mentor? *
Parent or Guardian Information:
If you or your child is a minor, please fill out the below information. Otherwise, you can move on to the
next section.
Name, Relationship, Address, Phone Number, Email Address *
Authorization

I agree that I would like to participate in Motor City Mentors mentoring program and authorize The Hope Project staff to contact me/my parent or guardian. I understand that not everyone who applies for the program is eligible to participate, and that even if I am eligible, there may be a wait before there is a mentor to match with me.
Mentees Signature *
Mentor Parent/Guardians Signature *
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