Mentorship Request
Please fill this out so we can properly assign you with a mentor
Sign in to Google to save your progress. Learn more
Are you interested in participating in The Rising Star Program in addition to ongoing mentorship? For more info go to:  https://www.blackmint.io/our-programs
Clear selection
Name *
What grade are you in? *
Gender *
Your email address *
How frequently would you like to meet up (virtually to start) with your mentor? *
Would you consider yourself an introvert or extrovert? *
What area of technology are you thinking of getting into right now? (Don't worry, we understand that this can change over time) *
Are you open to participating in workshops outside of mentorship sessions? *
Have you signed up for risingstar.blackmint.io? (We're still working on it so your feedback is important) *
Do  you have access to a personal laptop to work on projects BlackMINT may assign? *
Please provide the email address of a parent to ensure you have consent to participate *
Our goal is to increase the number of black kids in Canada pursuing tech careers and we need to track our progress. To that end, what ethnicity do you identify with? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Black Mentorship In Technology.

Does this form look suspicious? Report

Google Forms