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Application for HAWK Student Mentor Program
Application deadline: Wednesday, March 1, 2017
Name
Parent/Guardian Name(s)
Birthdate
Address
Home Phone
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-
Cell Phone
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Email Address:
Parent Email Address:
Parent Cell Number
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-
Emergency Contact Name
Emergency Contact Relationship
(i.e.- Mother, Father, Grandparent, etc.)
Emergency Contact Phone
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-
Do you prefer email or text?
- Select -
Text
Email
High School
High School Graduation Date
High School GPA
What is your race?
African-American/Black
Asian/Pacific Islander
Caucasian/White
Latino/Hispanic
Native American/American Indian
Other
Are you Hispanic or Latino?
- Select -
Yes
No
Have your parents or siblings attended college?
- Select -
Yes
No
If so, where?
Career/Major Academic Interest
Hobbies/Special Interests
Short Answer Questions
Please briefly answer each of the following questions
Do you plan to attend college?
Yes
No
What is the proudest moment of your life to date and why?
What makes you a leader?
Why do you want to be in the mentor program?
What days/times are you most available for an interview?
Submit Form
