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Your Information Applicant's Date of birth: mm/dd/yyyy   Due to laws regarding children's online privacy, this system will remove personal information fields for persons under the age of 13. In addition, those under the age of 13 will be prohibited from accessing pages that require personal information. For more information, please refer to the privacy statement. Gender: Click here Male Female Ethnicity: Click here Black/African American Asian/Pacific Islander Hispanic Native American/Indian/Eskimo White/Caucasian Other Applicant's First name: Applicant's Last name: Current grade level (or highest level of education completed): Click here 7th or Earlier 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade College Freshman College Sophomore College Junior College Senior Graduate Student High school graduation year: yyyy

Username and Password You will need these every time you wish to access or modify any of your information. Please choose something you can easily remember. Your username and password can be 5-12 letters long and cannot contain any spaces. Username: Use only characters a-z, 0-9, or "_"   Password: Password (repeat): In case you forget your password, please specify the question you would like to be asked, along with the answer to that question. Password hint question: Click here What city were you born in? What is your favorite pet's name? What is your favorite book? What is your favorite music group? What is your favorite television show? Password hint answer:

E-mail You can use your current email address to establish a UtahMentor account: OR Click on the checkbox below to have the email address be your new username@utahmentor.org: Applicant's E-mail address: Applicant's E-mail (repeat):   Check here if you do not have your own e-mail and would like to use your UtahMentor account as your primary e-mail. How did you hear about UtahMentor? Click here Financial literacy course Guidance counselor Parent Teacher/Advisor Utah Scholar's Initiative Other

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