1. Student Information Section

This application is for high school and college level young women who wish to serve as mentors in the GEE program.

Both groups may apply for middle school mentoring but only college level and young women entering college in the fall may serve as high school mentors.

* 1. First Name

* 2. Last Name

* 3. Street Address:

* 4. City:

* 5. State:

* 6. Zip Code:

* 7. Email address:
(It is very important the we have a valid email address here. All correspondence about the program is sent to this address.)