Mentoring and Internships Interested in The Meeting House Mentor and Internship Program? Please complete our application form: Your Name * First Name Last Name Date of Birth * MM DD YYYY Gender * Phone * (###) ### #### Email * Grade Level and School Name * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Information (name, email and phone) References (name, email, phone and relationship) Academic focus and intended major Extracurricular activities Your special interests, in art, dancing or sports, etc., that could be helpful in our program. Have you volunteered in the past and if so where? What do you hope to learn and offer through your volunteer experience with us? What days and times are you available to work in our program? Is there anything else you want to share about yourself with us? Thank you! We will be in touch shortly.