Youth Mentee Application

(To be completed by Parent/Guardian)
Application Questions
Please answer all of the following questions as completely as possible. The answers to these questions will aid us in the matching process.
Medical History
Please agree by checking each of the following:

Please read this carefully before signing:

We appreciate you and your child’s interest in her becoming a mentee. This application is intended as a means of informing and gaining the consent of the parent/guardian to allow their daughter to participate in the mentoring program.

After receiving this completed application, we will evaluate the information and notify you by email letting you know if your child has been accepted into the mentoring program. Much of the information that you supply in this application packet will be used to match your child with an appropriate mentor.

Therefore, the mentoring staff may, at times, need to access and share this information with prospective mentors and other parties when it is in the best interest of the match. However, we do not reveal names until there is an initial interest from the mentee, parent/guardian, and mentor based upon anonymous information provided about each other.

The cost to participate in the iSparkle2 EmpowHERment mentoring program is free.

By signing and submitting your name below, I attest to the truthfulness of all information listed on this application and agree to all of the above terms and conditions.