HSM Mentor Program Form - Student

If you are interested in having a mentor, please complete this form so we can learn more about you and what you are looking for in a mentor. This will help us ensure that we match you with the most appropriate mentor. If you are a parent filling out this form on behalf of your student, please make sure your student is interested in meeting with a mentor before completing the form. We find the best mentoring relationships happen when students are open and willing to participate.
I am a:
*Student First Name:
*Student Last Name:
*Date of Birth:
*Gender:
*School & Grade:
*Email:
*Cell Phone:
*Parent Name:
*Parent Email:
*Parent Phone:
*What is your involvement with Blackhawk Church and/or High School Ministries?:
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*What is your family background (do you have siblings, parents at home, etc.)?:
*What school or community activities do you participate in?:
*What are you considering/thinking about for post high school and career?:
*What are your interests and hobbies? :
*What are you passionate about in life right now?:
*How do you best connect with God?:
*How would friends/family describe you? (adventurous, intellectual, easy-going, outgoing, serious, quiet, lighthearted, etc.):
Any further comments about your spiritual journey you would like to share?:
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*Why are you interested in having a mentor?:
Have you ever been mentored before? Briefly describe your experience.:
*What qualities are you looking for in a mentor?:
If you have a particular person(s) in mind, please include their name and how you know them.:
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*Can you commit to meeting once a month with your mentor? If not, why?: