WPAFB STEM Outreach
Mentor Request Form

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* 1. Teacher Information

Name:

Email:

Phone Number:

School District:

School Name:

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* 2. Student Information

First Name(s) Only:

Grade Level:

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* 3. Subject Area or Project Type
Please specify the focus of the mentoring request. For example, Science Fair, Engineering Design, Robotics project, etc.

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* 4. Mentoring Goals
Please describe the specific goals or needs of the student mentorship. For example, project assistance, idea brainstorming, guidance on research, connecting with a professional in the field, etc.

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* 5. Preferred Mentoring Type

In-Person (during school hours)

Virtual (during school hours)

Email

Any option is fine

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* 6. Preferred Days and Times for Mentoring (if not using email option)

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* 7. Additional Information
Is there any other information that would be helpful for the mentor to know? For example learning style, accommodations, previous experience with projects, or any specific challenges.

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* 8. Scheduling and Coordination
Once your request is submitted, it will be shared with our volunteers. Once paired, teachers and volunteers will connect directly with each other to arrange mentoring sessions and plan for the student’s project needs.

Please Cc me (on all email communications) for awareness, but note that the scheduling and planning will be handled between you and the volunteer directly.

Please add additional questions below.