Thank you for your interest in the NEPP Mentoring Program! Please make sure you review the complete program guidelines and complete the form below.

Upon submitting the form, you will be taken to a page to make your payment. When directed to the payment page, please click on the $25 button and direct your donation to the 2021/2022 Mentorship Application Fee. Call (570) 270-4444 with any questions.

    Applicant Information

    Full Name*
    Address*
    City*
    State*
    Zip*
    Home Phone
    Cell*
    Grade (as of September 2021)*
    Age*
    Email*
    School Name*
    City*
    County*
    Instrument*
    Did you ever audition for this program in the past?* YesNo
    Do you play another instrument(s)?* YesNo
    If yes, which instrument(s)?
    Do you wish to be considered for a scholarship based on financial needs?* YesNo
    If YES, please fill out the Financial Aid application on our website.

    Other Contact Information

    Please supply the contact information of a parent as well as any private teacher you may have.
    Parent Name*
    Parent Email*
    Home Phone
    Cell*
    Parent Name
    Parent Email
    Home Phone
    Cell
    Teacher Name
    Teacher Phone
    Teacher Email*

    Audition Selections

    Video submissions must be received via Google drive at nepamentoring@gmail.com by Sunday, June 20, 2021.
    Audition selection 1*
    Composer*
    Audition selection 2*
    Composer*

    Signatures

    Please review the Mentoring Program Guidelines before submitting your application.
    Student Signature*
    Date*
    Parent Signature*
    Date*