Skip to content
Home
About Us
Register
Meeting log-in
Contact Us
Menu
Home
About Us
Register
Meeting log-in
Contact Us
Facebook
Twitter
Dribbble
Donate
An error occurred.
WE'RE HERE TO HELP
Register Today
What's Next Mentorship:
Guiding Teenagers to Success!
Registration
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Teens name
*
First
Last
Date of Birth
*
Grade
*
If between grades, list the grade the Teen will be in at the start of the next school year.
Why are you registering/ What is your Teens greatest need?
*
What would you like to see your Teen get out of this mentorship?
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Parent/Guardian Phone
*
Permission & Agreement
*
I agree and give my permission
I give my Teen here permission to attend this mentorship pursuant to all the terms and regulations that apply.
I agree to the following charges
*
Registration Fee - $ 150.00
Recurring payment x 3 months = $450 total
Payment Info
*
Submit
