Mentoring Application - Parent Form
Welcome to Chelsea Gheesling's Mentoring Program! Please fill out this form with as much detail as possible. All information is kept confidential. After you submit the form, we will contact you within the next 48 hours with the next steps.
Parent's Name *
Parent's Email *
Parent's Phone Number *
Daughter's Name *
Daughter's Age *
Daughter's Grade *
Daughter's Email *
Will the sessions be in-person or through Skype *
In-person sessions are offered within Metro-Detroit.
If the session is through Skype, please provide your Skype ID
Tell us about your daughter. What are her interests and what does she excel in? *
Is she currently facing any challenges? *
What is the main goal you want your daughter to accomplish through this mentoring program? *
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