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Mentor Application


Have you ever been denied when applying to volunteer or mentor?


Describe your present use of alcohol, tobacco, or any other drugs

Describe your past use of alcohol, tobacco or any other drugs

Have you ever been accused, investigated, arrested, and/or convicted of child abuse, neglect, or sexual molestation of a minor?


Have you ever been a victim of a crime, physical abuse, or sexual abuse?


Reference 1: Coworker

Reference 2: Friend

Reference 3: Supervisor

Describe 3 things you want for yourself from being a mentor (What is in it for me?)

What do you think will be difficult for you while being a mentor?

Given the schedule of training and other activity requirements for the year, what will you need to do to clear your calendar such that you can fully participate?
To support compatibility for the pairing process between the mentor and the mentee please list 4 interests, hobbies and activities you participate in
What experience and/or training do you have working with at-risk teenagers?

How comfortable would you be talking to a teenager about the following?