Mentor Questionnaire
As a mentor applicant this questionnaire will help supplement the answers on your application and help staff make the most appropriate mentor match. Some of the questions may be very personal and will be kept confidential. However, some of the information or personal qualities, interests, etc. may be shared with a prospective mentee and parent/guardian.

All information will be kept strictly confidential except as noted above.
Your First and Last Name *
Your answer
Email Address *
Your answer
Date *
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1. What is your current occupation? If retired, please share your past occupation and that you are retired. *
Your answer
2. Why do you want to be a mentor? *
Your answer
3. What do you think are your greatest strengths and weaknesses? *
Your answer
4. Do you have experience working with youth/young adults? If so, doing what? *
Your answer
5. What type of student would you like to be matched with? *
Your answer
6. What do you feel are some of the biggest challenges facing young people today? *
Your answer
7. Do you have any hesitation or concerns in working with this student population? *
Your answer
8. How do you expect to deal with any differences in ethnicity, religion, or values? *
Your answer
9. What topic would you consider inappropriate to discuss with your mentee? *
Your answer
10. What would you do if your mentee started using offensive language? *
Your answer
11. Will you be able to commit to mentoring one hour per week, at the school site, during the school day for the school year? *
12. If you needed to terminate your weekly meetings, how would you do so? *
Your answer
13. What do you hope to gain from your mentoring experience? *
Your answer
Comments or Questions:
Your answer
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