Mentee Application Form

Dear Prospective Mentee,

We are excited that you are interested in joining our NBloom mentorship program! Please fill out the form below so we can learn more about you and match you with a mentor who can best support your goals and growth.

Best regards,

SIstersNBloom Team

Full Name *

Select Age Range *

Preferred Language(s) *

Phone Number (if applicable) *

Address

City/Town

State/Province

ZIP/Postal Code

Country

Current School (if applicable) *

Current Grade/Level

Are you currently living in a group home or with family?

What are your favorite subjects or activities in school?

What hobbies or interests do you have outside of school?

Why are you interested in having a mentor? *

What do you hope to achieve through this mentorship program? *

Are there specific skills or areas where you would like help from a mentor? (e.g., leadership, confidence, schoolwork, planning for the future) *

What are some of your goals for the next year? *

Have you had a mentor or been part of a mentorship program before? If yes, please describe your experience

What qualities would you like in a mentor? (e.g., kind, good listener, experienced in certain areas) *

Do you have a preference for your mentor’s background or experience? (e.g., someone who has faced similar challenges, a particular career field) *

What type of activities would you like to do with your mentor? (e.g., talking about goals, learning new skills, doing projects together) *

How often would you like to meet with your mentor?

Weekly

Bi-weekly

Monthly

Other (please specify)

Preferred mode of mentoring *

Virtual

In-person

Hybrid

What days and times are you usually available for mentoring sessions? *

Are you willing to commit to the mentorship program for [3 months, 6 months, 1 year]? *

Yes

Do you need any special accommodations to participate in the mentorship program? (e.g., accessibility needs, language support) *

Is there anything else you would like us to know about you? *

Do you have any questions or concerns about the mentorship program?