G.E.M.S Mentee 2018 Application
Thank you for demonstrating an interest in becoming a GEMS Mentee!

Please complete all of the questions below to the best of your ability. After your submission, a member of the GEMS Team will contact you concerning the next steps of the application process within 3-5 business days.

Email address *
1. Name *
Your answer
2. Date of Birth *
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3. Home Address City State Zip *
Your answer
4. Phone Number *
Your answer
6. Name of Parent(s) or Guardian *
Your answer
7. Parent/Guardian's Contact Info *
Your answer
8. School Attending *
Your answer
9. Grade Level *
Your answer
10. Why do you want to be a part of the GEMS mentoring program? *
Your answer
11. Why would a mentor be someone you would benefit from? *
Your answer
12. Have you thought about your education beyond high school? If yes, what are your next steps? *
Your answer
13. Do you currently work outside of school? If yes, please give employer's, name, address and phone number *
Your answer
14. Days/Hours of employment:
Your answer
15. Do you participate in extra-curricular activities? If yes, please list them. *
Your answer
16. What extra activities do you enjoy in your spare time (music, reading, sports, art, cooking, etc.)? *
Your answer
17. Can you make the time commitments below? Monday & Wednesdays (4-7p) + one additional weekday (4-7p)? *
Your answer
18. If selected to be a part of this program, could you commit to participating in the program for one full school year? *
19.Is there anything additional you would like the G.E.M.S Team to know about you? If so, write a brief summary below. *
Your answer
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