Mentor Application
Prospective mentors, please answer the questions below. Should take less than 3 minutes
Email address *
Last Name *
Your answer
First Name *
Your answer
Gender *
Email Address *
Your answer
Cell Phone *
Your answer
Other Phone *
Your answer
Home Address ( Number, Street) *
Your answer
City *
Your answer
Zip Code *
Your answer
Employer Name
Your answer
Position
Your answer
Work Phone
Your answer
Interests *
Required
Educational Background *
Education Degree - List Area of Concentration and Year *
Your answer
Additional Languages Spoken
Are you willing to come and have lunch with your mentee once every 4 to 6 weeks at our school? *
Are you willing to visit mentee or plan an activity with mentee once or twice per semester outside of school premises? *
Are you willing to email or text your mentee once every 2 to 3 weeks to stay in touch and offer encouragement? *
Is there anything in you professional, ethnic or personal background that would help us better pair you with a student? Please explain. *
Your answer
What do you feel are strengths you can bring to this program? *
Your answer
I understand that this is at least for a one year commitment and I am open to a 4 year commitment, through the school career. *
I understand that I will required to complete a mentor program orientation. *
Within the past 10 years, have you been convicted of any felony or misdemeanor classified as an offense against a person, family, or an offence of public indecency, or in a violation involving a state/federally controlled substance? *
Are you under current indictment or has a district/county attorney accepted an official complaint for any of the offences in question above? *
Reference First and Last Name *
Your answer
Reference Phone Number *
Your answer
In making this application to be a volunteer, I understand Cristo Rey Atlanta routinely performs criminal and driving record checks of all volunteers for the mentor position I am applying. This check may be conducted if I sign below. If I fail to sign, it may be grounds for rejecting me as a mentor *
Your answer
I certify to the best of my ability that the information provided on this application is true and accurate. I understand that misinformation knowingly provided here, is grounds for dismissal. Please sign your name below. *
Your answer
A copy of your responses will be emailed to the address you provided.
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