NEW Mentor Application 2022-2023 DUE: June 27, 2022Active Mentors: Please DO NOT fill out this application! Look out for the End of Year form on June 1 where you will indicate how you would like to stay involved next year. If you have any questions, Slack message your Staff Pod Lead.

NEW Mentor Application 2022-2023
DUE: June 27, 2022

Active Mentors: Please DO NOT fill out this application! Look out for the End of Year form on June 1 where you will indicate how you would like to stay involved next year. If you have any questions, Slack message your Staff Pod Lead.

Program Applying To:

Contact & Personal Information

First Name

Last Name

Preferred Name (or Nickname)

Please spell your name phonetically (as it is pronounced)

For example: Aim-ee for Amy

Gender Pronouns

For example: she/her, they/them

What is your gender?

Home 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 Primary Phone Number

HomeMobile/CellWork

Secondary Phone Number

Primary Email Address

Type of Email Address

PersonalWork

Other email address:

Program Eligibility

Are you a woman-identifying or gender expansive adult who will be at least 25 years of age as of September 2022?

Girls Write Now requires that mentors devote an average of 6 hours per month to the program they participate in through 1-2 monthly workshops and regular pair sessions with your mentee.

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

Our program year runs from September to June.

In order to be eligible for Girls Write Now, you must be at least 25 years of age as of September 2022 and able to devote an average of 6 hours per month from September to June. At this time, you are unfortunately not eligible to participate in our programs.

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

Contact Information