Evanston Mentoring Day Application - Disability IN: Uinta County, WY

Participate In Our Annual Mentoring Day

October 20, 2021

Please list your area of career interest:

Choice 1:

Choice 2:

Choice 3:

List places you have mentored in the past

Place #1:

Place #2:

Place #3

Permissions:

Name of Child:*

I give my child, [name of child] permission to participate in Mentoring Day on Wednesday, October 20, 2021 from 8:00 - 1:30. I realize [name of child] will be excused from classes, but will need to make-up missed schoolwork.

Parent Signature:*

Date:*

Photo Release:

I understand that Mentoring Day can attract attention from the media & may be used for promotional purposes. Photos may be used at the discretion of NextGen Mentoring. Example: Publication of a photo in the local newspaper.

Parent Signature:*

Date:*

For more information contact Wanda Rogers at 307-783-6302 or director@di-ucw.org.

Application Deadline: September 21, 2021

THANK YOU!