ESI Application

Welcome and Thank You!

Thank you for your interest in joining the Every Student Initiative, a program of the nonprofit Be Great For Nate Inc. Please fill out this online application to begin the process of joining. Currently we are accepting applicants that live in or go to Portsmouth School. You must in in 9-12th grade or a soon to be 9th grader. You will need parent permission to apply to ESI so make sure you talk to your parent first. Thank you for interest in joining us in being great for Nate!

Please fill out the application and you will be contacted for an interview!

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* 1. Contact Information

First and Last Name

Address

Address 2

City/Town

State/Province

Email Address

Cell Phone Number

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* 2. What is your gender?

Female

Male

Prefer not to say

Other (please specify)

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* 3. What is your race or ethnicity?

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Multiracial or Multiethnic

Native American or Alaska Native

Native Hawaiian or other Pacific Islander

White

Prefer not to say

Another race or ethnicity, please describe below

Self-describe below:

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* 4. What grade are you in?

9th

10th

11th

12th

Incoming 9th grader

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* 5. How old are you?

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* 6. What school do you go to?

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* 7. Parent Contact Information

First and Last Name

Email Address

Phone Number

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* 8. Name and contact of one reference

Name

Relationship to you

Email Address

Phone Number

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* 9. What are your hobbies/interests?

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* 10. What makes you want to join ESI?

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* 11. Do you have parent permission to join?

Yes

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* 12. Student Signature

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* 13. Date

Date / Time

Date