Mentee Application
Only new youth need to fill out the form below. For any questions please contact Le"kedra Robertson at lekedra@micamped.org
First name *
Your answer
Last name *
Your answer
Country *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
What school are you currently attending? *
Your answer
What grade are you in? *
What location of MIC will you be affiliated with? *
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