MENTEE APPLICATION

The mentee enrollment has closed for the year. Please email us at info@thechauncygloverproject.org to learn more about when the next enrollment period will begin.

The CG Project - Mentee Application

The Chauncy Glover Project (CGP) is an extensive, hands-on mentoring program, created by Emmy Award winning ABC 13 News Anchor Chauncy Glover, to groom inner city teenage boys into upstanding and accomplished gentlemen. The program helps Black and Latino males who have potential but lack the guidance and support to achieve success after high school graduation through mentoring that is culturally and gender-specific. For more information, contact us at info@thechauncygloverprojecthouston.org or (832)558-1906.

CGP Mentee Information

Name *

First

Last

DOB *

T-Shirt/Polo-style Shirt Size *

Address (Current Residence) *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Parent/Guardian Information To be completed by parent.

Parent/Guardian Name 1 *

First

Last

Relationship *

Parent/Guardian Phone Number 1 *

Parent/Guardian Email 1 *

Parent/Guardian Name 1 (if applicable)

First

Last

Relationship (if applicable)

Parent/Guardian Phone Number 1 (if applicable)

Parent/Guardian Email 1 (if applicable)

Tell us a little bit more about yourself... To be completed by student.

How many siblings do you have? *

High School Attended *

Grade Level for next school year (2023-2024)? *

Current Grade Point Average (GPA) *

Do you live with both your parents? *

If you do not live with both your parents, who do you live with?

Do you plan to attend college?

Yes
No
I do not know if I want to attend college.

If you plan to attend college, which college would you like to attend?

What would you like to be when you finish high school?

What are your hobbies/activities? *

What are your strengths? (List the things you are good at doing.) *

What are your weaknesses? (List anything you need to work on or would like to learn.) *

Why do you want to be part of The Chauncy Glover Project Houston? *

Can you commit to attending regular monthly CGP empowerment sessions, after-school study hall, and other activities as required to complete the program? *

Yes
No
Maybe

If not, what would keep you from attending CGP empowerment sessions, after school study hall, and other activities regularly each month? Explain.

Is there any additional information you would like to share with the selection committee?

MENTEE APPLICATION

The mentee enrollment has closed for the year. Please email us at info@thechauncygloverproject.org to learn more about when the next enrollment period will begin.

CGP Mentee Information

Parent/Guardian Information To be completed by parent.

Tell us a little bit more about yourself... To be completed by student.

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