BCF Mentor Interest Form
Full name *
Your answer
Email address *
Your answer
Ethnicity (Please select all that apply)
Age range
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Cell Phone *
Your answer
Work phone
Your answer
Home phone
Your answer
Preferred Phone
Contact information we can share with other mentors *
How did you hear about our program? *
Your answer
Occupation *
Your answer
Employer *
Your answer
Employer Address *
Your answer
Colleges and degrees *
Your answer
What are your hobbies and special interests? *
Your answer
What do you believe you bring to the mentor relationship that will benefit a scholar? *
Your answer
If you had an important adult in your life in your teenage and/or college years, what are the qualities that you appreciated most in that relationship? *
Your answer
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