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SBCSC Mentor Application
Thank you for your interest in becoming a mentor for the South Bend Community School Corporation. Please answer the questions below to the best of your ability.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Age
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Race
*
1) American Indian or Alaska Native
2) Asian
3) Black or African American
4) Native Hawaiian or Other Pacific Islander
5) White
Hispanic or Latino or Spanish Origin of any race
Required
Permanent Address
*
Your answer
Phone Number
*
Your answer
Employer
*
Your answer
Job Title
*
Your answer
Work Number
*
Your answer
Can you be contacted at work?
*
Yes
No
Length of employment (with current employer)
*
Your answer
Highest level of education completed
*
High School
Some College
Bachelor's Degree
Master's Degree
Doctorate Degree
Vocational School
Other
If other, please explain.
Your answer
Are you currently mentoring a student in SBCSC?
Yes
No
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