Mentee
(Ages 12-18)

Fill out the registration form and click submit. We look forward to welcoming you to the SMH community.

SMH MENTEE REGISTRATION FORM

First name

Last name

Email

Phone (Please add 1 for US Country Code)

Birthday

Month

Day

Year

T-Shirt Size

XS

S

M

L

XL

2X

3X

4X

OTHER

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

COLLEGE or TRADE SCHOOL (if applicable)

COLLEGE ADDRESS

Country/Region

Address

Address - line 2

City

Zip / Postal code

PARENT NAME & NUMBER

Special Skills/ Hobbies/ Sports/ Activities

Allergies

T-Shirt and Activity Fee

$35

T-Shirt and Activity Fee Paid

Yes

No

Mentor Name

Mentoring Mentee Name

Terms & Conditions

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Privacy Policy

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Accessibility Statement

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Mentee (Ages 12-18)

SMH MENTEE REGISTRATION FORM

Mentee
(Ages 12-18)