2025 Army HBCU-MI SPARK Mentor Signup

"*" indicates required fields

Name*
Your Primary Email Address*
Please provide your professional email address. Information about mentor selections and other program-specific emails will be sent to this address.
Your Secondary Email Address
Optional. Please provide a secondary email address. This will only be used if there is an issue with your primary email address.
Please provide the phone number where you would prefer to receive calls from program personnel. This can be an office number or your mobile phone number.
Optional. Please provide a secondary number, to be used only if there is an issue with your primary number. This can be an office number or your mobile phone number.
Your Facility's Address*
Enter the address where any interns you mentor will work.
This field is for validation purposes and should be left unchanged.