1. Student Information Section

This application is for college level young men who wish to serve as mentors in the TREC program on June 16-20, from 8 AM-noon.

You may only apply to mentor if you are currently in college or will start college in the fall of this year (if will enter college in Fall 2014, must have participated in a previous TREC program).

* 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.)