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Please fill in the details below so that we can provide you with the most relevant information to you.

First Name*

Last Name*

Email Address*

Phone Number*

What best describes you?*

I am...

a parenta college studentan adult with no kidsa wise elder (senior)a student in high-schoola student in middle school

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🎉 You are almost there...

To help us serve you and your kids better, tell us what grade level your kids are in.

To help us serve you and your family better, tell us a little about you.

To help us serve you better, please tell us a little about you.

How many children do you have?*

What grade levels are your kids in?* (Check all that apply)

Pre-SchoolElementary School (Grade K-5)Middle School (Grade 6-8)High School (Grade 9-12)College

What college are you in?*

What year do you graduate?*

What is your major?*

What school are you in?*

What grade are you in?*

What school are you in?*

What grade are you in?*

What is your relationship status?*

Do you have siblings in school?* (Check all that apply)

Siblings in Elementary School (Grade K-5)Siblings in Middle School (Grade 6-8)Siblings in High School (Grade 9-12)Siblings in CollegeNone of the above

Do you have any grand children in school?* (Check all that apply)Grand kids in Elementary School (Grade K-5)Grand kids in Middle School (Grade 6-8)Grand kids in High School (Grade 9-12)Grand kids in CollegeNone of the above

Do you have siblings in school?* (Check all that apply)Siblings in Elementary School (Grade K-5)Siblings in Middle School (Grade 6-8)Siblings in High School (Grade 9-12)Siblings in CollegeNone of the above

Do you have any young relatives in school?* (Check all that apply)Relatives in Elementary School (Grade K-5)Relatives in Middle School (Grade 6-8)Relatives in High School (Grade 9-12)Relatives in CollegeNone of the above

What is your ZIP Code?*

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🙏 Awesome! Now for the final step...

Share any hurdles in your child's academic or personal growth that we could help overcome?

Share any hurdles in your grand children's academic or personal growth that we could help overcome?

What is your highest level of education?*

What is your profession?

What are your hobbies & interests? (So we can inform you about interest based activities)

Are you interested in being part of GEM's team? (Check all that apply)

MentoringTutoringOtherNone of the above

If interested in being part of GEM's team, what do you prefer? (check all that apply)VolunteeringPaid positionEither of the aboveNone of the above

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