Connecting Crowns Foundations -                 Mentee Intake Form
On behalf of Connecting' Crowns Foundations, we are excited to be part of your life journey.  We are dedicated to empower and guide you to be the successful resilient individuals that take control of your outcome despite life's challenges. We are passionate about helping you grow in every area of your life journey, be it academic, social or personal. As a Crown Foundations mentee, you will be advised, trained and counseled by a mentor who is fitting for you. We ask that you will be open to the process of learning and applying new coping skills that will in turn help you to achieve your life goals.
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We are dedicated to providing guidance, support, encouragement, empowerment, networking, and honest feedback.  
We are committed:
State your first and last name:
Parent or Guardian: What is your parent or guardian full name
What is your parent or guardian contact number and email address?
What is your email address?
What is your date of birth?
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State the name of your school and your grade level:
Which social media platform are you a member of?
What is the best way to reach you, 
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What is the best number to contact you?
All mentees are required to meet with their mentors for a total of 4 hours a month. As a Connecting Crowns mentee, do you agree to meet 4 hours a month and 1 hour a week?


How would you like to meet with with your mentee?
What are your hobbies?
What do aspire to become?
Who would say is your role model?
Initiate: I will take the initiative to ask my mentor  questions, to let him or her know my educational and professional interests and objectives, and to ask about his/her own experiences
I am not sure how to do this
I am very comfortable
Clear selection
  Honor your commitment: I will respect and express  appreciation for my mentor’s time and investment. I will respond in a timely manner to your mentor's questions and comments. 
Clear selection
  Be Teachable: I am willing to learn new things, obtain another perspective, and be responsive to suggestions and constructive feedback.  
Clear selection
  I plan to be open, correct any misunderstandings when they happen. I will get in touch with my mentor before a concern becomes a problem.   
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Briefly explain the mentoring experience you have had:
Have you worked with a mentor before? If so, briefly explain your experience
Check all challenges that you are currently facing either you or someone close to you?
What was the outcome and what were some challenges you faced? 
As a Crowns' Mentee, We ask that you are prepare for all  meetings with you mentor, to be honest & real and forward thinking.
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What have been your greatest achievements in life?
What extracurricular activities are you currently a part of?
Please provide any information or current challenges that .will help us to get to know you or your needs. (This is confidential)
A copy of your responses will be emailed to .
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