AKOG New Mentor Application

Use this form to apply to become an AKOG mentor. Applications must be received by October 1st.

First Name:
Last Name:
Age:
Year at Clark:
Phone:
Campus Box:
Preferred Email Address:
Projected Major:

Where are you originally from?

What do you remember about being 9, 10, 11, or 12?

What are three things you remember enjoying at that age?

If you could impart one message to all the girls in the United States what would it be and why?

What do you expect to gain from being a mentor?

What do you expect the girls to learn gain from AKOG?

What will you bring to AKOG?

Please list past experiences working with children and/or other experiences that you think are relevant to this program.

If you could be an animal, what would you be and why?

Are you a Women's Studies concentrator? Yes No
Are you committed to coming every Saturday? Yes No
Are you able to participate both semesters? Yes No
Are you able to commit to an all day training session on Saturday, October 16th? Yes No
How did you find out about AKOG?

Is there anything else you'd like to say or to let us know about you?