Mission Possible Mentor Application
Mission Possible! is a unique residential camping experience for all youth; special effort is made to recruit youth with special needs.
Youth who have completed 8th grade as of June 15 who would like to serve alongside a Texas 4-H Center Counselor and Adult Volunteers to provide a safe and fun camp experience for all.
A minimum of (10) ten 4-H Mentors will be selected to assist with Mission Possible, July 1-3, a three day camp for youth with and without disabilities, held at the 4-H Center. Mentor Training will be held on June 30th at the Texas 4-H Center.
4-H Mentors reside in the dorms & participate in all camp activities. As a Mentor, they may be asked to work individually with a camper needing special attention or with the entire group. Mentors will shadow the 4-H Center Counselor and be available to assist in whatever capacity that is needed.
Mission Possible! is a unique residential camping experience for all youth; special effort is made to recruit youth with special needs.

Applications are due by March 19, 2019. Mentor selections will be sent out by April 2, 2019 after the Leadership Team has reviewed all applications.

Please contact Cari Snider at cari.snider@ag.tamu.edu or 325-784-5482 if you have any questions.

Name *
First and last name
Your answer
County *
Your answer
District *
Your answer
Current Grade in School *
Your answer
Primary Email- We will use this to contact you with our selections (no school emails please) *
Your answer
Secondary Email *
Your answer
Phone number *
Your answer
Mentor Cell Phone Number (to communicate during camp activities) *
Your answer
Mailing Address *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Gender *
County Extension Agent *
Your answer
Have you been a Mission Possible Mentor before? If yes, what years? *
Your answer
Please tell us about your most important 4-H Projects and Activities *
Your answer
Have you attended any programs at the Texas 4-H Center before? Please list the events, weekend retreats, and camps you have participated in. *
Your answer
Can you swim? *
Summarize your most significant 4-H leadership responsibilities (offices held, leadership, or citizenship activities, etc.) *
Your answer
Please share a summary of your involvement in church, school, community, and other youth or civic organizations. *
Your answer
In a short paragraph please explain why you want to be a Mentor for Mission Possible. *
Your answer
What are your future plans? *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service