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Ujima Men's Collective's Protege Project
Protege Project Protege Application
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* Indicates required question
Name
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Your answer
Nickname
Your answer
Address
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Your answer
Age
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Your answer
Telephone Number
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Your answer
Email Address
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Your answer
Race/Ethnicity
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Black
African American
Caribbean
African Native
Other
Race/Ethnicity-Other
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Your answer
Briefly describe why you want a mentor?
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Your answer
If you agree to become a protege, you will be asked to agree to the following basic requirements: To be mentored as a Protege, you will be asked to make a minimum commitment of one year with openness to continue in the relationship on a long-term basis.
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Yes
No
Maybe
To attend a 2 hour Protege Orientation and Training before you will be considered for a one-on-one match with a Black same gender loving mentor.
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Yes
No
Maybe
To maintain weekly contact with your mentor either in person or by phone.
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Yes
No
Maybe
To maintain monthly phone contact with our Program Coordinator the Ujima Men's Collective Protege Project.
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Yes
No
Maybe
I understand the Ujima Men's Collective reserves the right to accept or decline proteges based on the information gathered. For reasons of confidentiality Ujima Men's Collective will not share this information or reasons of denial with any applicant.
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Agree
Disagree
I agree to be dedicated and dependable in receiving assistance from my Black same gender loving mentor to achieve success in my professional, spiritual, educational and emotional developmental pursuits.
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Yes
No
Maybe
Please describe any special interests that may be helpful in matching you and your Mentor (i.e. stamp collecting, roller skating, computers, football, music, painting, etc.):
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Your answer
Status
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Married/Partnered
Single
Seperated
Divorced
Please provide a brief biographical sketch.
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Your answer
Do you agree to have a background check?
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Yes
No
Maybe
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