WeClimb Parent Application
This short application will help us determine if your child is a good fit for the WeClimb Mentoring program. The application will take about 10 minutes to complete.  PLEASE ANSWER THE QUESTIONS HONESTLY. If you have any additional questions, please add them below or contact us at weclimbtn@gmail.com.

If you're enrolling more than one child, please submit a separate application for each child.

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Email *
Parent/Guardian's Full Name *
Your Child's Full Name *
Phone Number *
Street Address *
City & State (e.g. Chattanooga, TN) *
1. Describe your child's personality type? *
2.    What is your child's top two preferred learning styles? How do they learn best? (Only check 2 boxes.) *
3.    What is your child's current grade-point-average (GPA)? *
4. Has your child had any disciplinary problems at school due to behavior (i.e., expulsion, suspensions, detentions, etc.)? If YES: go to Question #5, if NO, go to Question #6. *
5. If you answered YES to #4, please provide a short explanation of the type of infraction and why?
6. How would you rate/describe your child's self-esteem (i.e., confidence level)? *
7. What do YOU think is your child's greatest challenge(s) (check as many that apply)? *
8. Briefly, in one sentence, what do you hope your child will receive by participating in WeClimb (i.e. your desired outcome)? *
9. Ask your child what they consider to be their greatest ACCOMPLISHMENT they're most proud of? *
10. Ask your child what they consider to be their greatest CHALLENGE? *
11.   How willing/open is your child to participating in a program like this? *
No interest
Very interested
12.   How willing are you to support your child in WeClimb (i.e. make sure they attend, are on-time, etc.)? *
Not sure
Most certainly
13.   Does your child have a cell phone so they can receive text messages? *
If yes, what is their phone number?
14.   Do you have reliable transportation? *
15.   Does your child have any pre-existing health conditions that could prevent him/her from engaging in strenuous physical activities (i.e., asthma, heart condition, vertigo, fractures, recent surgeries, etc.)? *
16.  Re-confirm Your Email Address *
If you have any additional questions, please indicate below. Thank you for allowing us to support you and your child; we take this responsibility very seriously.
A copy of your responses will be emailed to the address you provided.
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