Mentee Application


Parent/Guardian AND Applicant: Please read and consent to the eligibility requirements, the Role and Responsibilities, and Code of Conduct at the bottom of this form, before submitting this application. We will contact you in 7 to 10 days to schedule a follow up phone interview.

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Applicant Basic Information

Current Grade Level

Applicant Address Information

Applicant Contact Information

What is your preferred method of communication

Applicant Demographic Information



Is the parent/guardian’s address the same as the applicant’s?

Emergency Contact Information

Emergency Contact Information Is the emergency contact the same as the parent/guardian listed above?

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Program Questions for Applicant

Have you attended elementary and middle school in the U.S??

If you have not, how many consecutive years have you been enrolled in the U.S education system?

If you know the industry(ies) that interests you or would like to explore please select it/them from the list.

Do you have a gender preference for your mentor?


What motivated you to apply to the mentoring program?

Applicant Profile Questionnaire

Which of these skills could your mentor help you further develop?

How would you rate your abilities to solve problems with your friends?

How many times have you been on punishment or have been disciplined with a parent action required at school this year?

Do you get nervous when you have to speak in front of big crowds?

Do you like to save money?

Which one of these would you say you are?

Do you have a Job?

If you work during the school year, do you work after school or on weekends?

If you do not currently have a job, have you ever had a job?

How well do you get along with others?

Which subject area do you enjoy most ?

How often are you late for class?

Do you normally start arguments or try to break them up?

Do you feel like you are a good listener?

Do you get mad when people try to correct you?

Do you have any constraints that will limit your participation in the mentoring program?

If yes, please explain below

Tell us about your hobbies and other non-educational interests...

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Are you willing to record audio, videos, or send us useful information to add to the knowledge database?

Are you willing to participate in on-the-job experience such as shadowing, internships, job placements?

Are you willing to attend events such as training and webinars?

Applicant Availability

Referral Information

Do you know other people who would like to become mentors or mentees?


As the parent or legal guardian of this applicant, I attest that I, along with the mentee applicant, have read "The Mentee Code of Conduct" and "The Mentee and Mentor Roles and Responsibilities", from the mentee page, and we accept the responsibilities set forth in these documents. The applicant is currently enrolled in high school and I give them permission to participate in Mentor N Motion online mentoring program for the duration of the mentoring session

As the mentee applicant, I attest that I have read and accept the responsibilities and roles set forth for me in the Mentors and Mentees Roles and Responsibilities and the Mentee's Code of Conduct. This includes attending video chats and online meetings. I commit to the duration of the mentoring session. I am currently enrolled in high school.