SBHC Mentor Sign-In
Please ONLY add ONE student per form submission.
Email address *
Mentor's Name (case sensitive) *
Please type your name as it appears in our records.
Mentee's Name (case sensitive) *
Please type the mentee's name as it appears in our records. ONLY list ONE student per submission.
Date of mentor visit. *
The duration of the mentor visit. *
Please choose a duration.
Discussed with my mentee the following topic(s). *
Please check all that apply.
Additional request(s):
Clear selection
If you chose one of the contact options above, please provide either a phone number or email that you would like for the school representative to contact you via.
Comments other than contact request.
If you have any questions or issues please contact Cindy Wester at or Jennifer Sheffield at
A copy of your responses will be emailed to the address you provided.
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