Evanston Mentoring Day Application

Participate In Our Annual Mentoring Day

Explore a possible career path – spend time with an area business that matches your career interest.

You and your mentor will join us for the Disability:IN Uinta County Awards Celebration in Evanston. There is no charge, as you are a guest of our Youth Empowerment Program (formerly NextGen Mentoring).

Application Deadline

October 13, 2023

Evanston High School Mentoring Day

"*" indicates required fields

Name:*

Age:*

Address:*

City:*

Zip Code:*

Phone Number:*

Email:*

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 19, 2022, 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.