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MENTEE SIGN-UP FORM (for those seeking help)

Full Name

Email Address

Phone Number

What do you need help with?

What do you need help with?

If other please explain

What best describes you?

Highschool Student

If other please explain

Preferred Communication

Preferred Communication

A

Email

B

Text

C

Zoom / Video Call

D

No preference

Your General Availability

Your General Availability

A

Weekdays (Daytime)

B

Weekdays (Evening)

C

Weekends (Anytime)

D

Flexible

What do you hope to achieve by having a mentor?

Start Date You’d Like to Begin

Disclaimer Checkbox I agree to receive text and email communications from Rucker City about my mentor match, reminders, and future opportunities.

Disclaimer Checkbox I agree to receive text and email communications from Rucker City about my mentor match, reminders, and future opportunities.

I agree