Mentor Application - Interest Survey
This survey will help the Stay in School Mentoring Project staff know more about you and your interests and help us find a good match for you.
Your First and Last Name *
Your answer
Email Address *
Your answer
Date *
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DD
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YYYY
How did you hear about the Stay in School Mentoring Project (social media, community event, word of mouth, CCSD website / event ..... )? *
Your answer
Will you be mentoring on the behalf / under the name of any specific organization or company? If so name them below.
Your answer
What grade level(s) would you prefer to be matched with? *
Please check all that apply.
Required
What are the most convenient days for you to meet with your mentee? *
Required
What are the most convenient times for you to meet with your mentee? *
Please check all that apply.
Required
Preferred geographical areas of town *
Required
Do you have a specific school(s) that you'd like to mentor at? If yes please tell us the name(s) of the school(s) below.
NOTE: We can't guarantee that you will be placed at your school of choice.
Your answer
What jobs have you had, currently or in the past that may be of interest to a youth/young adult? *
Your answer
Describe any hobbies, unique experiences or activities that you bring to a potential mentee. *
Your answer
Please check all activities you participate in: *
Required
List any other strong areas of interest.
Your answer
Any other information that would help us facilitate a relationship between you and a mentee:
Your answer
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