Name
*
First Name
Last Name
Personal and/or School Email
*
Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Preferred Pronouns
*
Phone
*
(###)
###
####
Date Of Birth
*
MM
DD
YYYY
Current High School
*
Grade Level
*
Current GPA
*
Expected HS Graduation Date
*
MM
DD
YYYY
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Parent/Guardian Email
Household Size
*
What is your family income level?
*
Do you have health insurance?
*
Are you allergic to any food or medication? If yes, please list allergies.
*
In which industries are you interested in working? (select all that apply)
The following questions will be used to match you with a mentor.
In which industries do your parent(s) or guardian(s) work? (select all that apply)
*
What is the highest level of education you plan to complete?
*
What is the highest level of education that your parent(s) or guardian(s) completed?
*
Which languages (other than English) do you speak fluently? (select all that apply)
Which hobbies and interests do you enjoy? (select all that apply)
*
Which extracurricular activities are you involved in? (select all that apply)
*
Please answer the following questions. The purpose of this prompt is to simply get to know you and to understand how best to support you as a prospective mentee in MFC.
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What is one aspect of your personality that you like and how do you see it bringing positive change to the world around you?
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Who inspires you and what is your dream job? Why?
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What is a difficult challenge you’ve experienced and how did you navigate that experience?
Which MFC Program are you applying to?
*
*
How did you hear about MFC?
