Name (Student) *

First Name

Last Name

Phone (Parent) *

(###)

###

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Academic Grades *

From your 7th and 8th Grade years. Forward Mentoring is not just looking for all A students but we are looking for a diverse set of students to complement and grow from one another.

All As

As, occasional Bs

As, Bs, and occasional Cs

Bs, Cs, and occasional Ds

Cs, Ds, and occasional Fs

Ds and occasional Fs

Commitment *

If accepted, Forward Mentors will work work your Principal and School counselors to ensure that your class schedule works around your Forward Mentoring participation. Are you willing to actively participate in Forward Mentoring (in-school) Lunches twice a month during semester as well as participate in Summer activities (i.e., Summer retreat and monthly meetings)?

Yes

No

Digitally Sign (student) *

By typing your name in the box below you are giving your word that all the information above is accurate.

First Name

Last Name

Digitally Sign (parent) *

By signing your name in the box below you are giving your word that all of the information above is accurate and that you as the parent/guardian give approval for your child to participate in the Forward Mentoring program as long as they are students at Richards High School.

First Name

Last Name