M.A.L.E.S. Application

Thank you for expressing your interest in MALES. 

Complete the below application for membership. 

 

What is Your Gender Identification?
What is Your Ethnicity?
If "undecided" respond "N/A"
What Is Your Classification/Status?
First Generation College Student (Parents did not attend college)
Number, Street ,City ,State & Zip Code
(229)-903-1903
Instagram, Twitter, Facebook
if none, input "NA"
I would like to request a mentor.
I want to be a mentor.
type "yes or no" and the current date.
By submitting this application, I agree that the above information is true and accurate to the best of my knowledge and agree for its usage in MALES Mentors. I also understand my information will be used for review and selection into the MALES Mentoring Program.