Chopstix MENTEE Application (2016-2017)
Thank you for showing interest in the WashU China Care mentorship program!
This program aims to match a young adopted child to an older mentor who acts as a positive role model. Please fill out the form below with as much detail as possible. It will help us match your child to a mentor who has a similar personality and interests.

Applications are due by September 1st, 2016 by 11:59pm.

Name(s) of Parent(s)
Please separate names by commas.
Your answer
Name of Mentee
Your answer
Age of Mentee
Your answer
Grade in school of Mentee
Your answer
Email
We will primarily be communicating with you about playgroups through this email.
Your answer
Phone number(s)
Your answer
What are your expectations for this program?
Your answer
What kind of events and activities would you like your child to participate in?
We want your child to have fun with us! Please also let us know if there are activities in which you do not want your child to partake.
Your answer
What are some words you would use to describe your child?
These descriptors will help us make mentor/mentee pairings.
Your answer
What are your child's interests and hobbies?
Sports, crafts, cooking, musical instruments, quirky hobbies, special skills
Your answer
What are your child's favorite foods? Foods s/he dislikes? Any food allergies?
Your answer
Is there anything else you would like us to know about your child?
Your answer
Do you have any ideas for playgroups that you think your child would enjoy?
Your answer
Please use this space and let us know if you have specific concerns about safety during our playgroups.
We will take your comments into account when organizing playgroups.
Your answer
What are the best times for your child to attend a playgroup on the weekends?
Please be specific and list all possible times. This is important for scheduling purposes. Also, monthly large playgroups will have set dates, but small playgroup times are flexible and set each time by the mentor and the family.
Your answer
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