JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Laadli to Laadli Mentee Application
The Laadli to Laadli Program pairs Laadliyan (16+) with professional mentors (22+) in the community to help them navigate their academic and career pathways.
For more information, please feel free to reach out to programs@laadliyan.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is your full name?
*
Your answer
What is your date of birth? (please note, you must be 14+ to enroll in this program)
*
MM
/
DD
/
YYYY
Which city/country do you currently reside in?
Your answer
What is your current academic institution?
*
Your answer
What is your/ your guardian's phone number? (This will only be used if we are not able to get a hold of you by email)
*
Your answer
Which academic and/or professional field(s) are you interested in? (Please be as specific as possible as this will help us when pairing you with mentors)
*
Your answer
Do you identify as a South Asian Woman?
Yes
No
Clear selection
Are you an international student?
Yes
No
Clear selection
What are you hoping to gain from this mentorship program?
*
Your answer
Is there anything else you would like us to know about you when pairing you with mentors?
*
Your answer
How did you hear about Laadliyan?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Laadliyan Celebrating Daughters.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report