Mentee Application

The information provided on this application will be kept confidential. It will be used by personnel of Joanie Girl’s Heart. Submitting an application to Joanie Girl’s Heart does not guarantee acceptance.

Application Process

Step 1: Gather support documents:

  • 500 word essay describing yourself and your interest in pursuing a healthcare career
  • High School Transcript
  • 3 letters of recommendation-
    • Guidance Counselor
    • Teacher
    • Personal (non-parent)
  • Contact and Information Release Form

Step 2: Complete the online application:  ***Please be sure to have all of your support documents prior to starting the application.  You will not be able to save and return to your application.**

Step 3: Verify all documents are attached to your application. Incomplete applications will not be processed.

Candidate (Mentee) Information


Essay & Transcripts


Parent/Guardian Information


Emergency Contact Information


Letters of Recommendation

  • Please submit three letters or recommendation below. (Word document, PDF, Rich Text, Plain Text or Scanned Image)

Medical History


Application Signature

  • Joanie Girl’s Heart welcomes you and your child’s interest in becoming a mentee. This application is intended as a means of informing and gaining the consent of the parent/guardian to allow their daughter to participate in Joanie Girls Heart Mentoring Program.

    After receiving this completed application, a representative from Joanie Girl’s Heart will evaluate the information and contact you regarding your child’s participation. Information collected will be used to match your child with an appropriate mentor. If selected, you and your child will receive a bio and contact information for your mentor.
    • This application does not obligate my/our child to become a mentee.
    • The application does not obligate Joanie Girl’s Heart to interview, assign, or actively seek to assign a mentor to my/our child.
    • I give my informed consent and permission for my child to participate in Joanie Girl’s Heart mentoring program and its related activities.
    • I agree to have my child follow all mentoring programs guidelines and understand that any violation on my child’s part may result in suspension and /or termination of the mentoring relationship. (Please refer to Joanie Girl’s Heart, code of conduct)

Mentee Contact and Information Release

  • I hereby grant permission for Joanie Girl’s Heart to make contact with my child and conduct a personal interview for the purpose of applying to be a Joanie Girl’s Heart mentee. A staff member from Joanie Girl’s Heart may also contact my child while on school premises.

    I authorize Joanie Girl’s Heart to obtain any needed information regarding my child’s academics, behavioral records, conversations with teachers, counselors and other administrative staff. Any photographs taken by Joanie Girl’s Heart may be used for commercial and advertisement use only.

    I understand that any information collected will be kept confidential and will only be used solely for the purpose of Joanie Girl’s Heart Mentorship Program.

    Further, I understand, as part of Joanie Girl’s Heart application and interview process, I/we am/are aware that Joanie Girl’s Heart staff members are MANDATED Reporters and obligated to report any “suspicion” of child abuse or negligence to the proper authorizes.

Parental Clause

  • I herby agree to adhere to this Parental Clause during my child’s participation/involvement with Joanie Girl’s Heart Mentorship Program. We expect the parent(s)/guardian(s) to be integrally involved, cooperative and supportive of the student as well as the organization and its programs, activities and meetings.
    • Commit to attending the initial interview with my child and Orientation
    • Attend 2 workshops per year: Building Relationships and Communication Skills Workshops
    • Provide and/or arrange transportation to and from Workshops
    • Hold my child accountable for attendance to workshops and service learning outings.
    • Responsible for ensuring payment of my child’s fee’s for participating in the Cultural Immersion trips both Junior and Senior Year.
    • Hold my child accountable for items outlined in the Mentee Code of Conduct