Mentor Inquiry Form
Please complete the following application.
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
Your answer
Gender *
Building/Room/Campus Location *
Your answer
Campus Phone Number *
Your answer
Cell Phone *
Your answer
Email *
Your answer
Job Title *
Your answer
Years at CPCC *
Your answer
Specific Degrees earned *
Your answer
Specific Degrees pursuing
Your answer
Why do you want to be a mentor? What do you hope to gain from serving as a mentor? *
Your answer
Do you have any previous experience volunteering or working with young adults? If so, please specify. *
Your answer
What qualities, skills, or other attributes do you feel you have that would benefit our mentees? *
Your answer
Are you willing to communicate regularly and openly with program staff, provide monthly information regarding your mentoring activities, and receive feedback regarding any difficulties during your participation in the mentoring program? *
Can you commit to participate in the Man Up program for a minimum of one year from the time you are matched with a mentee? *
Would you be willling to work with a student that has a disability?
Are you available to meet with a mentee 2-4 hours per month? *
Are you willing to attend a mentor training session and quarterly meetings? *
3MP appreciates your interest in becoming a mentor. Please read and check each of the following: *
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