Remedee Mentor Application

Interested in mentoring our students? Please complete the form below and let us know how you can help our project grow.

Name: *

Your first and last name.

Address: *

Your street number, street and apartment.

City: *

State: *

Zip Code: *

Phone Number: *

Fax:

Email: *

Date of Birth:

Gender:

Male

Female

Languages:

Languages you speak.

Availability:

Please list the days of the week and times you are available for each.

Education:

Please list your formal education, including institutions and dates attended, major courses of study and degrees received.

Most Recent Projects:

Please enter the date, project name or employer, and your position in recent projects.

Specialized Filmmaking Skills:

How Did You Hear About Us:

How did you hear about Remedee?

What Interests You:

What interests you about becoming a mentor?

Skills To Contribute:

What skills will you contribute to the program?

What Will You Gain:

What do you hope to gain out of this program?

Experience Working With Youth:

What experience(s) do you have working with youth?

Young Person's Takeaway:

What would you like a young person to take away from this program?

Willing to Travel:

Yes

Are you willing to travel overseas for up to three weeks at a time?

Willing to Fund Travel:

Yes

Are you willing or able to fund all or most of the trip yourself?

Your Occupation:

What is your current occupation?

Other Experience:

Please list any other experience you feel might be of interest to us (Community Organizing, Popular Education, Media Literacy etc.)