Apply to BTS Mentorship Name * First Name Last Name Age * You must be 18+ to participate in the program. Email * Phone If international (non-US), please skip this question (###) ### #### Discord username * We use a free messaging service called Discord. All your communications with your Mentor will take place on this platform. If you don't have an account yet, register one at https://discord.com/register Time zone * Mountain Central Pacific Eastern GMT (UK) Central Europe (CET) Indian Standard (IST) Australian Central Australian Western Other Gender * This will help us match you with someone. Female Male Other I am open to being matched with: * Select all options that apply. Male Female Other Top 3 interests * Select a maximum of 3 options below: Music Traveling Movies & Films Reading Religion & Spirituality Workout & Physical Health Fashion & Design Art & Creativity Podcasts & Information Sports Gaming Top 3 genres of music * Select a maximum of 3 options below: Rap/Hip-Hop Pop/Mainstream Rock/Alt Country Hispanic K-Pop Electronic Christian Music Other Mental Health Topics * Select a maximum of 3 options below based on how important they are to your story: Abuse & Trauma Addiction Anxiety Bullying Dating Issues Depression & Grief Drugs & Alcohol Eating Disorders Family Issues Friendship Issues Hopelessness Loneliness Marriage & Divorce Parenting Issues Physical Health Issues Self-Harm Self Worth & Identity Sexual & Gender Identity Stress & Overwhelm Suicidal Thoughts How did you find out about the BTS Mentoring program? * A friend told me about this program Someone from HeartSupport reached out to me directly I follow HeartSupport on one of their social platforms Brittany or Matty Mullins Jake Luhrs I saw an ad on Google Other Are you open to answering demographic questions in the future? * PLEASE NOTE: This information does NOT affect whether or not you are accepted into the Beneath The Skin Peer to Peer Mentoring Program. This helps us learn more about who we serve and how to better serve them. It is not a requirement to complete any of the demographic information. Yes, I am open to it No, I don't want to answer demographic questions EMERGENCY CONTACT Every applicant submits contact information for a loved one in case of emergency. Your contact person must be over 18 yrs old. First & Last Name of your emergency contact * First Name Last Name Email of your Emergency Contact * Phone of your Emergency Contact * Country (###) ### #### Relationship to You of your Emergency Contact * So we can know how to address them Address of your Emergency Contact * This is required for and will only be used in emergency situations. Address 1 Address 2 City State/Province Zip/Postal Code Country Thank you for applying to the BTS Mentorship program! We will send you within 1 hour an online training/introduction to the program so you can get familiar with it and what to expect from it Once you complete the training, we will actively look after someone to match you with!
