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The HITEC Foundation Mentorship Program Application


If you would like to participate as a Mentee, please fill out the following form. All Information submitted will be kept confidential.


By completing the application form, you agree to the goals and purpose of the mentoring program. The HITEC Foundation encourages an open exchange of information and ideas between members participating in the program. However, the HITEC Foundation cannot and does not review such communications and does not guarantee or endorse the accuracy of information exchanged between mentor and mentee. You agree that you will participate in the mentor program in a manner consistent with the HITEC Foundation mission and its vision.

You further agree to completely release the HITEC Foundation, and its directors, from all claims, judgements, demands, liabilities, and actions that you may have arising out of, or in any way relating to, your participating in the mentorship program.

In connection with, and in consideration of my participation in the HITEC Foundation Mentorship Program, referred below as PROGRAM, I hereby give the HITEC Foundation and those acting on its behalf, authority, consent and permission to:

(i) Record and/or reproduce my appearance, image, silhouette, voice and/or any other aspects of my physical likeness, as well as any materials provided by me, if any, in whole or in par, on film, video tape, audio tape, photograph, online and/or any other medium or platform, and use my name and/or any other biographical or personally-identifying information, for, or in connection with, any such recording, and

(ii) Copyright any such recording, and any materials related thereto, in the name of the HITEC Foundation and otherwise use, reuse, copy, edit, revise, produce, publish, display, exhibit, broadcast, distribute, sell, license, and promote any such recording, and any materials related thereto (including any materials provided by me), in whole or in part, anywhere in the world, in any medium or platform now known or hereafter discovered, for any purposes which the HITEC Foundation and those acting on its behalf, may deem appropriate.

With the intention of binding myself, and my heirs, assigns, and legal representatives, I hereby WAIVE AND RELEASE any and all rights and claims which I may have, now or in the future, against the HITEC Foundation and its officers, employees, members, agents and representatives, for any and all damages or injuries of whatever kind suffered by me in connection with my participation in the PROGRAM, any recording thereof, any use of any such recording, and the other matters set forth herein, except for those arising out of the willful misconduct, gross negligence or intentional torts of the above parties. Without limiting the foregoing, I also hereby WAIVE AND RELEASE any right that I may have, now or in the future, to inspect and/or approve any recording of the PROGRAM, and/or any materials related thereto.

I hereby represent and warrant that I am eighteen years of age or older and have every right to contract in my own name in the above regard. I state further that I have read the above terms, prior to its execution, that I understand and am fully familiar with the contents thereof, and that the same shall be governed by, and construed in accordance with, the laws of the District of Columbia.
1. Official transcripts
2. Autobiography
3. Resume
4. Letter of recommendation