Mentor Application
This form will take an estimated 15-20 minutes to complete and will require photograph proof of Driver License and Auto Insurance. Before you start this application, please have both of those ready.
Legal Name
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Sex
*
Male
Female
Gender Identity
*
Female
Male
Nonbinary
I do not wish to disclose at this time
Other
Pronouns
*
She/her/hers
He/him/his
They/them/their
I do not wish to disclose at this time
Other
Race/Ethnicity
Preferred Phone Number
*
Please enter a valid phone number.
Is this a mobile phone capable of receiving text messages?
*
Yes
No
Alternate Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Check 5 Items In which You Believe You Would Be Able To Best Offer Your Mentee
*
Productive Advice
Emotional Support
Exposure to New Experiences or Opportunities
Academic Support
Life Skills
Self Discovery
Spiritual Guidance
Navigating Conflict
Job Search
Getting Drivers License
Emotional Regulation
College Search
Connect With Resources
Be a Sounding Board/Effective Listening
What values are important to you, and how might they help you support and connect with a teen in foster care?
*
What drives your commitment to mentoring with HOPE585?
*
What are you looking to accomplish as a mentor, both for your mentee and for your own personal growth?
*
Do you feel confident in your ability to connect with and support youth from diverse communities, including various cultures, religions, and lifestyles?
Yes
Maybe
No
Other
Do you feel confident in your ability to connect with and support youth from diverse communities, including various cultures, religions, and lifestyles?
*
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Personal Experience
We want to establish teams that have complimentary schedules, similar passions or interests, and valuable resources or experiences that could benefit everyone involved. The information on this application helps us accomplish these goals.
Have you ever been a foster parent?
*
Yes
No
Have You Ever Lived In Alternative Housing Arrangements (Foster Care, Group Home, Shelter, With Relative, Adoptive Parents?
*
Yes
No
Do you have any personal or professional experience with the foster care system, adoption process or other systems that impact individuals in marginalized or underserved communities?
*
Yes
No
If yes, please briefly share your experience.
Have you previously been involved in a mentorship program or worked with a youth-serving organization?
*
Yes
No
If yes, please include the name of the organization and the timeframe in which you participated.
Do you have any experience with informal youth mentorship?
*
Yes
No
If yes, please include details along with the timeframe of your involvement.
In your own words, what makes you a great fit to mentor a young person?
*
How comfortable are you mentoring a youth who expresses a gay, lesbian, transgender, or other LGBTQ+ identity?
*
How comfortable are you mentoring a youth who expresses a gay, lesbian, transgender, or other LGBTQ+ identity?
Comfortable
Not comfortable
Open for further discussion
Would you like to disclose any personal history with substance use or addiction that may be relevant to your role or support at Hope585?
Yes, I would like to share
No, I would not like to share at this time
Would you like to disclose any personal history with substance use or addiction that may be relevant to your role or support at Hope585?
*
Please Share Below
Would you like to receive faith-based training as part of your mentor preparation
Yes
No
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References
(If retired or self-employed, please provide personal references and/or a past or present professional reference)
Professional reference:
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Position
*
Years Known
*
Character Reference
(non-family, 5+ years relationship)
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Years Known
*
Character Reference
(non-family, 5+ years relationship)
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Years Known
*
Employer
Present Occupation
*
Present Employer
*
How long have you been with your current employer?
*
Schedule and Availability Information
Are you able to commit to meeting with your mentee in person twice a month?
*
Yes
No
Are you able to commit to connecting with your mentee weekly through phone, text, or social media?
*
Yes
No
Do you intend to stay in the immediate area for a minimum of one year from the beginning of the mentorship matching process?
*
Yes
No
Please list any days/times when you are UNAVAILABLE to meet with your mentee/BTH team.
Unavailable
Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please list any days/times when you are AVAILABLE to meet with your mentee/BTH team.
*
Available
Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you applying to be a motor with a group of people you already do life with or as an individual?
Group
Individual
If you're applying to mentor as part of a group, please provide the full names of your fellow applicants:
Note: This question helps staff identify individuals interested in being part of a team. Please remember that each person applying to become a mentor must complete their own individual application.
Personal Interests
*
Talkative
Quiet
*
Funny
Serious
*
Energetic
Laid Back
I Use The Following Social Media Platforms (Check All That Apply)
Facebook
Instagram
Snap Chat
Tik Tok
Twitter (X)
LinkedIn
How do you prefer to communicate (check all that apply)
Call
Text
In person
Social media
Three words that I think describe me are:
*
My favorite genre of television/film/books is:
*
My favorite subject in school was:
*
The thing I hated most about school was:
*
For me, the things that matter most in life are:
*
What kind of support would you have wanted/needed as a teen?
*
What kind of support do you naturally offer others (encouragement, problem-solving, advice, listening, etc.)?
*
In my free time I like to: (Check all that apply)
*
Agree
Describe
Play/watch sports
Watch TV
Play music
Make music
Read
Play video games
Draw, paint
Write, compose
Shop
Eat
Other:
How did you hear about HOPE585?
*
Friend
Lunch & Learn
Staff/Board Member
Facebook
Tv or Article
Website
Email
Other
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Upload Documents
Please Upload a Photo of the Front of Your Driver's License
*
Browse Files
Drag and drop files here
Choose a file
Upload pictures (front) of your license
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Please Upload a Photo of the Back of Your Driver's License
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Choose a file
Upload pictures (back) of your license
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Please Upload Proof of Valid Auto Insurance Policy
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Please make sure all information is visible
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Please upload a photo of yourself that captures your personality.
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Submit
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