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AMP Mentee Application Form

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. This is the first step in the application process and should take approximately 15-20 minutes to complete.

If you would like assistance in completing this form, please contact the AMP Program Coordinator, Megan Perera at megan.perera@autismmentorshipprogram.org.

Example: she/her, he/they
Example: 01/01/2000
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.
For the purposes of our research study with the University of Minnesota, we require proof of an official autism diagnosis as a criterion to participate in AMP this year. We hope to expand to include self-diagnosis in the future.
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.
This includes your house number, street name, and apartment/unit number if applicable. This information will only be used to confirm that you live in Minnesota.
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, you can email megan.perera@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!