Inspire Social Success Project Workshops & Mentor Program Registration Form (2026)

The Inspire Social Success Project (ISSP) Workshop & Mentoring Programs are designed to empower teens to reach their fullest potential! ISSP programs support students in strengthening social skills, building meaningful connections with peers and trusted community professionals, and play an active role in creating a safer, healthier future together. These ISSP projects are presented to Albuquerque High School Students by Emerge Motivation Initiatives (EMI) in partnership with AmeriCorps. 

ISSP Workshops engage students in meaningful, hands-on learning sessions that support their growth as individuals and as contributing members of their communities.

ISSP Mentorship provides personalized, one-to-one support in which a trusted community professional offers a listening ear and thoughtful guidance to empower each teen to succeed academically, grow socially, and thrive within their community. 

All mentors undergo background checks, and mentoring sessions will take place at Albuquerque High School during regular school hours.

At this time, not every student who registers will be selected for the mentorship program as available mentors are limited. Selection will be based on a combination of interest, as well as academic and social goals.  

Please complete the form below to register for the ISSP Workshop & Mentoring Program
Sign in to Google to save your progress. Learn more
Email *
Were you referred? If yes, how so?
STUDENT PARTICIPANT INFORMATION
Full Name of Student Participant *
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Age
Current Grade Level *
Name of School Attending *
Phone Number *
PARENT/GUARDIAN INFORMATION
Parent/Guardian Full Name
 *
Relationship to Participant
 *
Email
 *
Phone *
Emergency Contact Name *
Emergency Contact Phone Number *
PERMISSIONS & MEDIA RELEASE
Do you grant permission for your student to participate in the ISSP Workshop activities?

All workshops are conducted in a larger group setting.
 *
Do you grant permission for your student to participate in the ISSP One-to-One Mentorship program? 

All mentors undergo background checks, and mentoring sessions will take place at Albuquerque High School during regular school hours.
*
Do you grant permission for your child to be photographed for program related documentation and/or promotional purposes?
 *
Does the participant have any allergies or health conditions that we should be aware of? If yes, please provide details.
I understand that food/snacks may be provided and I am responsible for communicating any known allergies.
 *
Required
FAMILY & HOUSEHOLD INFORMATION
The following questions help us improve our programs and seek funding to support youth and families in our community. Your responses are kept confidential.
Is anyone in your household active duty or a retired Veteran?
 *
Number of household Members?
Do you or any others in your household have interest in the following? (check all that apply)
CLOSING QUESTIONS & NEXT STEPS
Do you or your student have any additional questions or concerns?
Thank you for registering! You’ll receive a confirmation email shortly. 

We will be in touch with updates and more details for upcoming ISSP workshops and mentorship assignments. 

For any questions, please contact Destinie Otero (EMI's VISTA Leader) at vistaleader@emiprojects.info
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Emerge Motivation Inatitatives.

Does this form look suspicious? Report

Google Forms