"“Youth Mentored for a Better Future “" Mentor Program
MENTOR ASSESSMENT, RULES, AND CONSENT FORM
Email address *
First name *
Last name *
How old are you *
Desired age group to be paired with
Clear selection
Gender *
Are you married or single? *
Do you have any children? If so, how many? *
What is your profession? *
Mentees are looking for guidance and support concerning their academics and future career. Based on this, what are you looking to bring to your mentee? *
I understand that I will be assigned to a mentee with the same gender as me. *
I understand that I will have to do a soft background check and am willing to pay for the $30 expense *
I understand that I will have to sign a code of ethics statement. *
I did receive the handbook acknowledgment form. *
I understand that all of my interactions with my mentee are private and I am required to keep it between the YBF team and the family. *
I understand that I am required to sign a confidentiality agreement. *
Do you have any previous experience as a mentor? *
If yes, how long were you a mentor?
Describe your past experience as a mentor if any?
I understand that being a part of YBF's program will require my commitment for a minimum of 10 weeks *
Do you have any foreseeable conflicts? *
If previously answered yes, please explain
I understand that I have to be an example to my mentee and profanity is strongly forbidden. *
I understand that I entirely taking responsibilities for anything neglectful on my part that doesn't go with YBF's policies and procedures *
Meeting Options *
Required
I 100% indemnify and assume all liabilities resulting from failing to follow YBF's policies and procedures. *
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