Youth Guidance Mentoring Academy - Initial Mentor Application

First Name required

Last Name required

Email Address required

Home Phone

Business Phone

Mobile Phone required

Address (residence) required

Address (mailing address if different than above)

How Can You Make a Difference in the Life of a Child in Need?

Would you like to be a Group Mentor? As a Group Mentor, you would be matched with a group of 3-4 children and spend at least 2 hours a week with that group for 6-8 weeks. required

Would you consider mentoring an individual child? This would be one-to-one mentoring for one year, for a minimum of 2 hours per week. required

Special Volunteer Skills - would like to teach a program in our Mentoring Academy (i.e., Music, Science, Art, etc.) required

Please Specify:

Where did you hear about the Youth Guidance Program?

Education:

High School Graduate required

College Graduate

Currently Enrolled in College

Major area of academic training:

Employment Information:

Are You Employed?

Where?

What is your position?

What hours do you work?

Additional Information

What are your hobbies and recreational interests?

Have you ever worked with children before, teenagers or younger? required

If so, describe briefly:

What age group would you prefer to work with (please check):

5 - 10

10 - 14

14 - 18

No preference

List Organizations with which you have been or are affiliated:

Why are you interested in volunteer work with children? required

What types of activities are you interested in doing as a mentor? required

I want to subscribe to your Newsletter

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Initial Mentor Application

Thank You!

Youth Guidance Partners

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