Dr. JAM Mentor Application
Mentor Information
Last Name *
First Name *
Age *
Mobile Phone Number *
E-mail Address *
What College/University Do You Attend? *
Background Information
Have you ever been accused, arrested, charged, or convicted of child abuse or molestation? *
Have you ever been convicted of a felony? *
Are you an illicit drug user? *
Have you ever been convicted of an alcohol or drug related crime? *
Mentor Commitment
Can you commit to the Dr. JAM Calendar Year (OCT - MAY) *
Can you commit to spending 4 hours a month with your mentee? *
Can you commit to meeting your mentee twice a month? *
Can you commit to contacting your mentee once a week. (text, email, call, etc...)? *
Can you commit to communicate regularly with the program coordinator and submit activity logs (via website) *
What's your major? *
What are you outside interests besides school related activities? *
What organizations are you a part of? *
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