Ladies of Favor Mentee Inquiry Form

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Thank you for your interest in Ladies of Favor, Inc. We are an empowerment agency that enhances self- esteem, embrace spiritual guidance, promote purity and abstinence and build leadership and sisterhood. If interested in what we have to offer, please complete this form in its entirety.

There is a simple process that determines the eligibility and participation of each participant.

1. Express interest in program via Inquiry Form.
2. Participate in Orientation/ Interview.
3. Submit Completed Application along with copy of Birth Certificate, Insurance Coverage, Latest Report Card
4. Submit Membership Fee*
5. Participate in program with a 1 year commitment.

*A minimal membership fee is due at the time of acceptance. Some payment plan options have been provided to meet your needs. There are only a limited number of scholarship opportunities awarded per year.

I look forward to getting to know each of you! Please feel free to contact us at 404-889-6812, ladiesoffavor@hotmail.com, or www.ladiesoffavor.com if there are any questions.

Sincerely,

Dr. Gabrielle Starr, MSW
Founder & Executive Director

General Information

Today's Date *

YYYY

Referred By: *

Are you a returning student to Ladies of Favor, Inc. *

Yes

Program Designation *

Please check the box that applies to the applicant's age group.

Priceless Princess (Elementary School)

Gorgeous Girls (Middle School)

Lovely Ladies (High School)

Required

Mentee Contact Information

Mentee's Full Name *

Age *

Date of Birth *

YYYY

Grade *

Grade Point Average (GPA)

School *

Home Street Address *

City, State *

Zip Code *

Home Phone

Cell Phone *

List any health or behavioral conditions *

If there are no health or behavioral conditions, please type None Present.

Are you interested VIP Mentoring & Coaching*? *

VIP Mentoring & Coaching is exclusive for girls that could benefit from exclusive 1 to 1 mentoring services with an experienced, skillful practitioner who provides support, individual coaching, goal setting, lifestyle mapping and behavior modification in order to provide special quality time with the child. Ideal for girls involved in multiple activities or in need of private structured guidance and modeling. VIP mentoring and coaching will help build self esteem, leadership skills and character development.

Yes

Are you interested in individual counseling for your daughter? *

Yes

Parent Contact Information

Are you interested in enrolling your daughter in Ladies of Favor Dream Academy, a private Christian academy for girls, to meet educational needs? *

Yes

Parent/Guardian Name *

Please Check the box below if the address is the same as above.

Address is the same as the applicant

Relationship *

Home Phone Number

Cell Phone Number *

Email Address *

Preferences and Interests

Tell us about personal hobbies, interests, and things you like to do in your free time. *

List any extracurricular activities

In what areas would you like to see improvement or change in daughter? *

Submit

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