ArkCDA - Request a Mentor Form

Complete the information below and click the button to Submit the form. Fields marked with a "*" are mandatory. If you have a mentor preference (Click HERE to see a list). You will be contacted within 24 hours after a mentor has been assigned to you. Please contact info@arkcda.org if you have any questions.


*Name:
*School:
*Email:
*School Phone:
( )   -
Home Phone:
( )   -
Best time to contact:
Mentor Preference (Optional):

Verify Authentication Code: