Mentorship Program Application

MVTV Mentorship Program Application

Sign up for Martha's Vineyard Community Television Mentorship Program, designed to provide hands-on learning experiences in community mediaproduction and television broadcasting.

Full Name:

Date of Birth:

Age:

Address:

Phone number:

Email address:

School (if applicable):

Current Grade:

Emergency Contact

Name:

Relationship:

Phone number:

Availability :

What days are you generally available?

How many hours per week are you available?

2-4 hours

5-8 hours

9-12 hours

12+ hours

Parent/Guardian Acknowledgment

I understand that participation in the MVTV Mentorship Program may include studio activities, field productions, educational workshops, and the use of media production equipment under staff supervision.

Date:

Parent/Guardian Signature:

*I understand and agree that electronically typing my name constitutes a legally binding signature. I agree that the electronically stored copy of my signature, authorizations, and documents will be considered the true, accurate, and enforceable record. I will not contest the admissibility or enforceability of these documents.

Applicant Acknowledgment

I certify that the information provided in this application is accurate and complete to the best of my knowledge.

Date:

Applicant Signature:

MVTV Mentorship Program Application

Emergency Contact

Interest & Experience

Personal Goals

Availability :

Short Response Questions

Parent/Guardian Information (For Applicants Under 18)

Parent/Guardian Acknowledgment

Applicant Acknowledgment