Thank you for showing interest in the Buck Out MVMT Mentor 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

Phone

(###)

###

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Current City/Location

HBCU Affiliation

HBCU Attended/Attending

Name of Dance Team(s) You Were/Are a Part of

Number of Years on the Dance Team

Mentorship Focus

What are you hoping to teach/mentor on?

(e.g., choreography, performance, technique, freestyle, etc.)

Availability & Preferences

Best Days/Times for Mentorship Sessions

Preferred Communication Method

Text

Video chat

In-person

Additional Information

Is there anything else we should know about your dance background or mentorship goals?

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Buck Out MVMT Mentor Application