Student Application

Name *

First

Last

Email *

Home Phone *

Mobile Phone

Other Phone

Street Address *

City *

State *

Zip Code *

School *

How did you hear about the ASPIRE program? *

What do you hope to gain through the ASPIRE mentorship program? What are the specific areas in which a mentor can assist you? *

Describe your current community involvement, extracurricular activities, volunteer work, paid work, etc. *

Describe an achievement that you are most proud of – academic, athletic, community involvement, volunteer experience, school leadership, church experience, etc. What about that experience makes you proud? *

What career interests do you have? *

Sponsor Name *

First

Last

Your Sponsor should be someone who can describe how you will benefit from being an ASPIRE student mentee. The individual, a non-family member, like a coach, teacher, pastor, guidance counselor, etc., should provide insight into how a mentor might help you grow as a person and student

Sponsor Email *

The ASPIRE Program hosts scheduled monthly events, attendance at these events is the most heavily weighted factor in scholarship determination. *

If accepted into the ASPIRE Program, I commit to actively participating in the program (i.e. attending monthly scheduled events and engaging with my mentor.