Scholastic REAL | Implementation Guide

R.E.A.L. Mentor Application Form

Name:

(First)

(M.I.)

(Last)

Home Phone: (

)

Cell Phone: (

)

Mailing Address:

City:

State:

Zip:

Name of Employer:

Title:

Occupation:

Employer Address:

City:

State:

Zip:

Work Phone: (

)

Email Address:

Which grade level (preK–8) do you prefer—if any?

Which school?

PERSONAL INTERESTS:

Hobbies:

Favorite book(s):

Do you have children?

If yes, how many?

Ages?

Languages spoken other than English:

Please EMAIL this form to:

Or FAX this form to:

SCHOLASTIC R.E.A.L. 13

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