1. Mentorship Application

  2. Application Information

    We accept applications on a rolling basis and will consider qualified candidates through Friday, December 17, 2021. Because spots in the program are limited, we strongly encourage students to submit applications as soon as possible. Along with the application, applicants must submit their latest report card and a 300-word essay (Essay Prompt: What are your education and career goals?). Following the initial application review process, semi-finalists will be notified by mid-January. Semi-finalists will be virtually interviewed at our Virtual Orientation and Screening Program held on Saturday, January 15, 2022.

    ONLINE PROGRAM DATES

    RMM workshops are conducted on Saturday mornings from 9:00 a.m. to 12:00 p.m., including breaks.

    Participants are required to attend and participate in each online workshop to successfully complete the program. At the end of the program, a virtual graduation ceremony is held on the Sunday afternoon following program completion. During the graduation ceremony, each participant will be recognized with a digital certificate for completing the program along with a gift of up to $100.00. Students receive $20 per session in which they fully attend and participate.

    The Online RMM program will be in session on the following dates:
    • Saturday, January 22, 2022
    • Saturday, January 29, 2022
    • Saturday, February 5, 2022
    • Saturday, February 12, 2022
    • Saturday, February 19, 2022

    The Virtual Orientation & Screening Program will occur Saturday, January 15th.
    The Virtual Closing Graduation Ceremony will occur Sunday, February 20th.

    If you prefer to complete the application offline, please click here to download a hard copy of the application. Then email your application, report card and essay to


  3. First Name*
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  4. M.I.
    Please let us know your middle initial.
  5. Last Name*
    Please let us know your last name.
  6. Address Line 1*
    Please provide an address.
  7. Address Line 2
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  8. City*
    Please provide a city.
  9. State*
    Please select a state.
  10. Zip*
    Please provide a valid zip.
  11. Home Telephone Number*
    Please provide a phone number.
  12. Applicant Email Address*
    Please enter email address
  13. Birth Date*
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  14. School Name *
    Please let us know your school name and street address.
  15. School Street Address*
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  16. School City*
    Please provide a city.
  17. School Telephone Number*
    Please provide a school phone number.
  18. Grade Level*
    Please select a gender
  19. Name of Mother/Guardian*
    Please give a name of Mother/Guardian
  20. Mother’s/Guardian's Occupation *
    Please let us know your mother’s occupation
  21. Mother’s/Guardian's Business Number
    Please provide a phone number.
  22. Mother's/Guardian's Email*
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  23. Mother's/Guardian's Cell *
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  24. Name of Father/Guardian
    Please give a name of Mother/Guardian
  25. Father’s/Guardian's Occupation
    Please let us know your father’s occupation
  26. Father’s/Guardian's Business Number
    Please provide a phone number.
  27. Father's/Guardian's Email
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  28. Father's/Guardian's Cell
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  29. Name of your Guidance Counselor*
    Please give a name of Parent(s)/Guardian(s)
  30. What is your guidance counselor's email address?*
    Please enter email address
  31. What is your overall grade point average for the present school year?*
    Please enter a valid G.P.A
  32. What are your favorite school Subjects?*
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  33. What are your hobbies?*
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  34. In what ways do you desire to benefit from your participation in this program?*
    Please let us know in what ways do you desire to benefit from your participation in this program?
  35. Please describe any leadership and community service activities that you have performed this year.*
    Please describe any leadership and community service activities that you have performed this year.
  36. How did you hear about us?*
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  37. Essay
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    Attach your 300 Word Essay. Essay Prompt: What are your education and career goals?
  38. Report Card
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    Attach your latest report card.
  39. Supporting Materials [Essay & Report Card] can also be emailed to us at
  40. *
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  41. Form Security
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  43. After clicking submit, you will be taken to a "Thank You" webpage. If you are not taken to the "Thank You" page, please review your application to make sure you completed all of the required text fields. Incorrectly filled text fields will be highlighted in red. Then resubmit.