Entradas Mentee Registration Form
Please keep in mind that this form will be utilized to create the best match possible with our potential mentee & mentor candidates.

Thank you for your time.
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Name: *
First and Last name
Email: *
Phone number: *
Is this a Cell phone? *
May we contact you via Text? *
Ethnicity: *
How long have you lived in Pittsburgh? *
Reminder
The purpose of this tool is to help you get a real picture of where you are - if you're not honest, you'll end up with a picture of someone else, not yourself, and that won't help you become who you want to be!
Answer these questions as honestly as you can:
Which best describes you? *
*Please note that this program is not available to students however PMAHCC offers a separate student mentorship program. Please email MelanieMarie@pmahcc.org for information on this program.
Interest of Support: Check all that apply *
Required
Please give a brief description of the specific area that you would like assistance in. *
Describe you ideal Mentor. *
What else should we know? *
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