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AMP Mentee Application Form

NOTE: At this time, all of our mentee slots have been filled for the Fall 2023 – Spring 2024 session.  If you complete this application, we’d be happy to add you to our wait list and contact you if there is an opening, and/or add you to our roster for the 2024-2025 session.  

Thank you for your interest in the Autism Mentorship Program (AMP). Please visit our Eligibility page to review the eligibility criteria for mentees.

We’re excited that you are interested in being mentored! We would like to know more about you.

If you would like assistance in completing this form, please reach out to us at info@autismmentorshipprogram.org.

Example: 6/26/2023
Example: she/her, he/him, they/them
Example: 01/25/2008
We are gathering this information because some mentees want to be matched with mentors that share similar gender identities.
We are gathering this information because some mentees want to be matched with mentors that share similar racial/ethnic identities.
We require this information for the affiliated University of Minnesota evaluation study of AMP.
If you are 18 years old and your own guardian, put your name here.
This is the email we will use to contact you. It should be an email that you can access regularly.
This is the phone number we will use to contact you. It should be a phone that you can access regularly.
Due to our limited resources, we can only allow Minnesota residents who live in the listed seven counties.
This includes your house number, street name, and apartment/unit number if applicable.
Please have the APPLICANT complete this question (help from guardians/others is allowed, but the content should come from the applicant).
If you have questions after completing this form, please email us at info@autismmentorshipprogram.org.
AMP is partnering with the University of Minnesota to conduct a research study on the effectiveness of AMP for autistic people. Because this research is vital to the future expansion of AMP to other counties and states, we ask that all AMP mentees participate in the research study for the 2022-2023 program year.

After you submit this application, the AMP team will review it for eligibility and get back to you as soon as possible.  Thank you for applying!