Free Mentoring Program Application Form

Full Name

Gender

• Male

• Female

Mobile Number

Email

Current Address

Permanent Address

Facebook Profile

Twitter Profile

LinkedIn Profile

Skype ID

Blog Link

School Name

School Phone Number

School Contact Person

School Type

• Public

• Private

Current Grade

Graduate Date

Have you ever applied to American universities?

Are you participating in any other mentoring program? If yes, which one?

• Opportunity Funds - EducationUSA

• Personal Prep Scholars - Fundação Estudar

• BSCUE

Interested Major

Other Course

Hobbies/Interests

In no more than 100 words explain why you want to participate in the My Community's Keeper Mentor Group Program

Some say social media is superficial, with no room for expressing deep or complex ideas. We challenge you to defy these skeptics by describing yourself as fully and accurately as possible in the 100-character limit of a tweet.

Writing Supplement Prompts: Choose the one you are writing about.

• What are you passionate about?

• Describe an experience where you were unsuccessful in achieving your goal. What lessons did you learn from this experience?

• What movie, poem, musical composition, or novel has most influenced your life and the way that you view the world?

• How are apples and oranges supposed to be compared?

• Imagine looking through a window at any environment that is particularly significant to you. Reflect on the scene, paying close attention to the relation between what you are seeing and why it is meaningful to you.

Writing Supplement

Mother's Name

Age

Profession

Father's Name

Age

Profession

How many people live in your house including you?

Recommendation Letter

If you have any additional file, please attach it here