Application JSHS Mentoring ApplicationFullname First NameLast Name Password Personal Emai. (No school emails please)I would like to apply as a Mentor Applicant Mentee CellArea CodePhone NumberAddress Street Address Street Address 2 City Region Postal Code Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda S. Georgia and S. Sandwich Islands Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Soviet Union Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands US Virgin Islands Uzbekistan Vanuatu Venezuela Viet Nam Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Country Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda S. Georgia and S. Sandwich Islands Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Soviet Union Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands US Virgin Islands Uzbekistan Vanuatu Venezuela Viet Nam Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Time Zone (UTC-12:00) International Date Line West (UTC-11:00) Coordinated Universal Time-11 (UTC-10:00) Hawaii (UTC-10:00) Aleutian Islands (UTC-09:30) Marquesas Islands (UTC-09:00) Coordinated Universal Time-09 (UTC-09:00) Alaska (UTC-08:00) Baja California (UTC-08:00) Pacific Time (US & Canada) (UTC-08:00) Coordinated Universal Time-08 (UTC-07:00) Yukon (UTC-07:00) Arizona (UTC-07:00) Chihuahua, La Paz, Maza (UTC-07:00) Mountain Time (US & Can (UTC-06:00) Central America (UTC-06:00) Central Time (US & Canada) (UTC-06:00) Easter Is (UTC-06:00) Saskatch (UTC-06:00) Guadalajara, Mexico City, Monte (UTC-05:00) Bogota, Lima, Quito, Rio Branco (UTC-05:00) Chetumal (UTC-05:00) Eastern Time (US & Canada) (UTC-05:00) Haiti (UTC-05:00) Indiana (East) (UTC-05:00) Havana (UTC-05:00) Turks and Caicos (UTC-04:00) Caracas (UTC-04:00) Asuncion (UTC-04:00) Atlantic Time (Canada) (UTC-04:00) Cuiaba (UTC-04:00) Sant (UTC-04:00) Georgetown, La Paz, Manaus, San Juan (UTC-03:30) Newfoundland (UTC-03:00) Brasilia (UTC-03:00) Cayenne, Fortaleza (UTC-03:00) City of Buenos Aires (UTC-03:00) Greenland (UTC-03:00) Montevideo (UTC-03:00) Salvador (UTC-03:00) Saint Pierre and Miquelon (UTC-03:00) Punta Arenas (UTC-03:00) Araguaina (UTC-02:00) Coordinated Universal Time-02 (UTC-02:00) Mid-Atlantic - Old (UTC-01:00) Azores (UTC-01:00) Cabo Verde Is. (UTC) Coordinated Universal Time (UTC+00:00) Dublin, Edinburgh, Lisbon, London (UTC+00:00) Monrovia, Reykjavik (UTC+00:00) Sao Tome (UTC+01:00) Amsterdam, Berlin, Bern, Rome, Stockholm, Vienna (UTC+01:00) Belgrade, Bratislava, Budapest, Ljubljana, Prague (UTC+01:00) Brussels, Copenhagen, Madrid, Paris (UTC+01:00) Casablanca (UTC+01:00) Sarajevo, Skopje, Warsaw, Zagreb (UTC+01:00) West Central Af (UTC+02:00) Windhoek (UTC+02:00) Amman (UTC+02:00) Athens, Bucharest (UTC+02:00) Beirut (UTC+02:00) Cairo (UTC+02:00) Damascus (UTC+02:00) Chisinau (UTC+02:00) Harare, Pretoria (UTC+02:00) Gaza, Hebron (UTC+02:00) Helsinki, Kyiv, Riga, Sofia, Tallinn, Vilnius (UTC+03:00) Istanbul (UTC+02:00) Jerusalem (UTC+02:00) Kaliningrad (UTC+02:00) Tripoli (UTC+03:00) Baghdad (UTC+02:00) Khartoum (UTC+03:00) Kuwait, Riyadh (UTC+03:00) Minsk (UTC+03:00) Moscow, St. Petersburg (UTC+03:00) Nairobi (UTC+03:30) Tehran (UTC+04:00) Abu Dhabi, Muscat (UTC+04:00) Astrakhan, Ulyanovsk (UTC+04:00) Baku (UTC+04:00) Izhevsk, Samara (UTC+04:00) Port Louis (UTC+04:00) Saratov (UTC+04:00) Tbilisi (UTC+04:00) Volgograd (UTC+04:00) Yerevan (UTC+04:30) Kabul (UTC+05:00) Ashgabat, Tashkent (UTC+05:00) Ekaterinburg (UTC+05:00) Islamabad, Karachi (UTC+05:00) Qyzylorda (UTC+05:30) Chennai, Kolkata, Mumbai, New Delhi (UTC+05:30) Sri Jayawardenepura (UTC+05:45) Kathmandu (UTC+06:00) Astana (UTC+06:00) Dhaka (UTC+06:00) Omsk (UTC+06:30) Yangon (Rangoon) (UTC+07:00) Novosibirsk (UTC+07:00) Bangkok, Hanoi, Jakarta (UTC+07:00) Barnaul, Gorno-Altaysk (UTC+07:00) Hovd (UTC+07:00) Krasnoyarsk (UTC+07:00) Tomsk (UTC+08:00) Beijing, Chongqing, Hong Kong, Urumqi (UTC+08:00) Irkutsk (UTC+08:00) Kuala Lumpur, Singapore (UTC+08:00) Perth (UTC+08:00) Taipei (UTC+08:00) Ulaanbaatar (UTC+08:30) Pyongyang (UTC+08:45) Eucla (UTC+09:00) Chita (UTC+09:00) Osaka, Sapporo, Tokyo (UTC+09:00) Seoul (UTC+09:00) Yakutsk (UTC+09:30) Adelaide (UTC+09:30) Darwin (UTC+10:00) Brisbane (UTC+10:00) Canberra, Melbourne, Sydney (UTC+10:00) Guam, Port Moresby (UTC+10:00) Hobart (UTC+10:00) Vladivostok (UTC+10:30) Lord Howe Island (UTC+11:00) Bougainville Island (UTC+11:00) Chokurdakh (UTC+11:00) Magadan (UTC+11:00) Norfolk Island (UTC+11:00) Sakhalin (UTC+11:00) Solomon Is., New Caledonia (UTC+12:00) Anadyr, Petropavlovsk-Kamchatsky (UTC+12:00) Auckland, Wellington (UTC+12:00) Coordinated Universal Time+12 (UTC+12:00) Fiji (UTC+12:00) Petropavlovsk-Kamchatsky - Old (UTC+12:45) Chatham Islands (UTC+13:00) Nuku'alofa (UTC+13:00) Samoa (UTC+13:00) Coordinated Universal Time+13 (UTC+14:00) Kiritimati Is Competition Region Alabama Alaska Arizona Arkansas California Northern California Southern Chicago Connecticut DoDEA Europe DoDEA Pacific Florida Georgia Great Plains Greater Washington, D.C. Hawaii and Pacific Heartland Illinois Indiana Intermountain Kentucky Louisiana Maryland Michigan Mississippi Missouri New England Northern New England Southern New Jersey Northern New Jersey Southern New York-Long Island New York-Metro New York-Upstate North Carolina North Central Ohio Oregon Pennsylvania Philadelphia and Delaware Puerto Rico South Carolina Southwest Tennessee Texas Virgina Virtual Washington West Virginia Wisconsin/Upper Peninsula Michigan Wyoming and Colorado Gender Female Male Prefer not to disclose Grade Level 9th Grade 10th Grade 11th Grade 12th Grade Mentoring Level Mentor Mentee Current Position TitleYears in Current Position <1 years 2-3 years 4-5 years 5+ years Research Category Biomedical Sciences Chemistry Engineering & Technology Environmental Sciences Life & Behavioral Sciences Math & Computer Science Medicine & Health Physical Sciences Project Type New Project Continuation Project Please provide a description of your research.