NEW Mentee Application 2022-2023 Due: June 27, 2022

NEW Mentee Application 2022-2023
Due: June 27, 2022

Program Applying To:

Contact Information

First Name

Last Name

Preferred Name (or Nickname)

Please spell your name, or preferred name, phonetically (as it is pronounced)

For example: Aim-ee for Amy

Pronouns

For example: she/her, they/them

What is your gender?

Date of Birth (mm/dd/yyyy)
Note: You must be between 14 and 24 years old (or in at least 9th grade) as of September 2022 to apply as a mentee.

Home Street Address

Apartment Number

City

State

Zip Code

Neighborhood/ District/County

Home Borough

Home Neighborhood (e.g. Morissania)

Home Neighborhood (e.g. Crown Heights)

Home Neighborhood (e.g. Lower East Side)

Home Neighborhood (e.g. Astoria)

Home Neighborhood (e.g. Tompkinsville)

Primary Phone Number

Type of Phone Number

HomePersonal Mobile/CellParent's Mobile/CellOther

If other, please specify:

Primary Email Address

Type of Email Address

PersonalSchoolParent'sOther

If other, please specify:

Program Eligibility

Are you a woman-identifying or gender-expansive young adult who will be 14-24 (or in at least 9th grade) as of fall 2022?

Mentees must be 14-24 or in at least 9th grade at the start of the 2022-23 school year.

Girls Write Now requires that mentees devote an average of 6 hours per month to the program they participate in through 1-2 monthly workshops and regular meetings with their mentor.

Please confirm whether you can commit to a monthly participation average of 6 hours.

In order to be eligible for Girls Write Now, you must be a woman-identifying or gender-expansive young adult between the ages of 14-24 (or in at least 9th grade) and able to devote an average of 6 hours per month. At this time, you unfortunately may not be eligible to participate in our programs.

I acknowledge I may not be eligible to participate in Girls Write Now and this may affect my application status.

Contact Information