Thank you for showing interest in the Buck Out MVMT Mentee Program! Please complete the application form, and we will review your submission and get back to you as soon as possible.

Personal Information

Full Name

First Name

Last Name

Date of Birth

YYYY

Phone

(###)

###

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Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current School

Current Grade

Parental Contact Information

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Phone Number

(###)

###

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Program-Specific Questions

Which HBCU(s) are you considering attending?

Which auxiliary program(s) are you interested in?

Majorette

Cheer

Color Guard

Dance Team

Dance Major

How do you hope to grow personally and professionally through this program?

Describe a time when you had to push beyond your limits to achieve a goal.

What do you hope to gain from the mentorship program?

Why do you want to be a part of Buck Out MVMT?

Additional Information

Any special skills or experience in dance? (Optional)

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Buck Out MVMT Mentee Application