Mentor application
Thank you for your interest in becoming a mentor with Kids On The Rise. Please complete the following application. You will be contacted shortly with information regarding the background check and training.
Name *
First and last name
Your answer
Email *
Your answer
Preferred Phone number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Occupation (current and/or former) *
Your answer
Spouse name or other adults in your household *
Your answer
License Plate Number *
A copy of your current driver's license and insurance card will be kept in your file.
Your answer
Personal References *
Please include contact information for three personal or business references whom we can contact regarding your application.
Your answer
School Preference (s) *
Please select all schools from which you would prefer to mentor a student.
Required
I would work best with children/youth in the following grades: *
Please select all that apply
Required
Please share with us the experience and skills you have for mentoring children and youth as well as some hobbies and interests that you might like to share with a child. *
Your answer
I certify that the information supplied on this application is correct and accurate to the best of my knowledge. In addition, I give permission for Kids On The Rise to contact my references and conduct a criminal background check. *
Please type your name below as your agreement to this statement.
Your answer
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