Peer Mentorship Application (for mentees) 2025-2026

The cost is $80 per term. Lessons can either be 30-minute sessions once a week for 8 weeks (eight sessions in total), or 1-hour sessions once every other week for 8 weeks (four sessions in total). Students who participate in the Peer Mentor Program are expected to attend all lessons.

Should a student find it necessary to cancel a lesson, the instructor must be notified at least 24 hours in advance. Any last-minute cancellations will not be made up and will count toward the total number of lessons received by the student.

Once lessons have begun, there will be no refunds issued for that term. All lessons must be completed by May 16th, 2026.

If you have any questions or concerns about the mentorship program, please contact our Community Engagement Coordinator: maluhia@portlandyouthphil.org

Student Name: Student Name: First Last
Student's Preferred Pronouns:
Phone Number (if over 18) Phone Number (if over 18) - ### - ### ####
Student Email:
Parent/Guardian Name (if under 18)
Parent/Guardian Email (if under 18)
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School Name for 2025-2026 Year:
School Grade for 2025-2026 Year
Age
What instrument do you plan on practicing during your mentorship?
How long have you been playing this instrument?
How did you hear about PYP?

How did you hear about PYP? Student Referral Community Event Sibling in PYP School/in music class Other Other
Please list THREE (3) days and times that you are consistently available to meet with a mentor:

*Reminder: Lessons are 30-minute sessions once a week over 8 weeks OR 60-minute sessions every other week over 8 weeks.

(i.e. Mondays 4-6pm, Wednesdays 2-5pm, Saturdays all day)
Which Term are you applying for? You may apply for more than one at this time.

*We will follow up in regard to payment once a mentor has been matched with you*

Which Term are you applying for? You may apply for more than one at this time.

*We will follow up in regard to payment once a mentor has been matched with you* Fall Term (Oct. 11th-Dec. 6th) Winter Term (Jan. 3rd-Feb. 28th) Spring Term (Mar. 14th-May 9th)
Do you have any questions or concerns at this time?