China Care Brown Mentorship Application

If you have worked with a mentor and would like to continue with this student please make sure to include their name and contact information (email or cell phone number).

If you are a returning family in need of a mentor you will be matched before any families new to the program are matched.

If you are not able to participate this year please email Kathy at m30s15@aol.com

* Required

For Mentees

Name *

Age *

Grade in School *

Brithday

Gender *

Ethnicity *

Favorite Color

Favorite Book

Favorite Movie

Favorite Subject at School

Favorite Sport

Favorite Chinese Food

If you could plan a day with your mentor, what would you want to do?

For Parent/s

Parent's name(s) *

Address

Phone (home/cell) *

Email *

Does your child have any allergies? *

Have you participated in China Care Brown’s Mentorship program before?

Do you have a gender preference or specific mentor you would like your child to be paired with?

No preference
Female
Male

Why are you interested in having a mentor for your child?

What about your child’s personality would be helpful for a mentor to know?

Tell us about your child’s interests, hobbies and talents:

List several activities your child might enjoy doing with their mentor:

Is there anything else you would like us to consider while matching your child with a mentor?

Would you like to have your child participate in Mentorship Plus (Mentorship Plus is the additional program where families can also meet with their mentors outside of monthly meetings)? By agreeing to participate in Mentorship Plus, families are responsible for initiating meetings and providing mentors with transportation to and from Brown University. In addition, Mentorship Plus families will have financial responsibility for the additional meetings with their mentors.

Would your child be interested in participating in an older children mentorship program at this time or in the near future? Mentorship's older children component (for middle school ages) would meet at the same time as Mentorship but would focus on one project for the entire year (learning calligraphy, a volunteer project, etc).

Yes, my child would like to participate this year
Yes, my child is interested in participating in the future
No

We encourage all families to maintain phone or email contact with all mentors about attending monthly meetings. Registration fee is $25/semester for FCC RI families and $35/semester for non FCC RI members, this fee will cover supplies for monthly meetings. Checks can be made out to Leslie Kosky and we ask you to have a check ready by the first meeting (9/26). Additionally we will be asking families to contribute snacks and beverages during monthly meetings. Deadline for registration is September 10th, Thursday

Meeting Space and Dates

We will be meeting this year in J. W. Wilson 201 and 202 (The new building across from Faunce on the corner of Waterman and Brown St). It wasn't our first choice but the rooms are big with long tables. Remember parking is always a challeng so plan accordingly. Mentorship dates for the first semester meeting from 4-6PM: 9/26 10/24 11/7 11/21 12/5 There will also be a carnival on 10/3 (2-5PM) hosted by CHINA CARE BROWN students.